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首页> 外文期刊>Allergy & clinical immunology international: official organ of the International Association of Allergology and Clinical Immunology >Clinical Experience with Topical Corticosteroids and Other Therapies
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Clinical Experience with Topical Corticosteroids and Other Therapies

机译：外用皮质类固醇和其他疗法的临床经验

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The safety and efficacy of antihistamine/mast-cell stabilizers, nonsteroidal antiinflammatory drug (NSAID), and topical corticosteroids was demonstrated in clinical studies of patients with different types of ocular allergy and inflammatory conditions. A comparative clinical study of the efficacy and tolerability of olopatadine hydrochloride 0.1% ophthalmic solution and loteprednol etabonate 0.2% ophthalmic suspension in a conjunctival allergen challenge model demonstrated that olopatadine reduced the acute signs and symptoms of intermittent (seasonal) allergic conjunctivitis (IAC) more than loteprednol in the early phase of the allergic reaction. Another comparative clinical study between ketorolac tromethamine 0.5%, a topical nonsteroidal antiinflammatory agent, and loteprednol etabonate 0.5% investigated the effect of these agents in controlling inflammation after cataract surgery. It was concluded that ketorolac was as effective as loteprednol in this study. In a 4-week study of giant papillary conjunctivitis (GPC), loteprednol etabonate 0.5% significantly improved clinical signs and symptoms of GPC compared to placebo. Incidences of elevated intraocular pressure (IOP) and other adverse events were low in both treatment groups. In two 6-week placebo-controlled IAC studies, loteprednol etabonate 0.2% showed higher efficacy than placebo with complete resolution of symptoms such as bulbar conjunctival injection and itching. The safety profile of loteprednol etabonate was similar to that of placebo. The incidence of elevated IOP, defined as pressure increases of >10 mmHg, was low for both loteprednol etabonate and placebo. Two studies on patients with acute anterior uveitis were performed, in which the efficacy and safety of loteprednol etabonate 0.5% was compared to predhisolone 1.0%. Loteprednol etabonate was slightly less effective than prednisolone in each study. However, combined data from these studies demonstrated a lower incidence of elevated IOP in the loteprednol etabonate group than the prednisolone group. Retrospective analysis of long-term data of loteprednol etabonate in the treatment of IAC and persistent (perennial) allergic conjunctivitis (PAC) demonstrated a very low incidence of cataract formation in patients treated with loteprednol etabonate 0.2% for at least 12 months. These data suggest loteprednol etabonate represents a safer treatment option to ketone corticosteroids, in particular when used for "short bursts" of up to 2-week periods. A placebo-controlled, randomized, parallel group, single center study comparing the therapeutic effects of 0.1% olopatadine hydrochloride and 0.5% ketorolac tromethamine demonstrated that both agents were effective in alleviating the clinical signs and symptoms of IAC even though they have different pharmacological mechanisms. However, olopatadine relieved ocular itching significantly better than ketorolac. The safety and efficacy of 0.5% ketorolac tromethamine and levocabastine in the treatment of IAC were compared in a multi-center, double-masked, randomized, parallel group clinical trial. It was found that both treatments were effective and well tolerated in this patient population.
机译：抗组胺药/肥大细胞稳定剂，非甾体类抗炎药（NSAID）和局部皮质类固醇的安全性和有效性在具有不同类型的眼部过敏和炎性疾病的患者的临床研究中得到了证实。在结膜变应原激发模型中对盐酸奥洛他定0.1％眼药水和洛替泼诺0.2％眼药水混悬液的疗效和耐受性的对比临床研究表明，奥洛他定能减轻间歇性（季节性）过敏性结膜炎（IAC）的急性体征和症状洛替泼诺在过敏反应的早期阶段。另一种局部非甾体类抗炎药酮咯酸氨丁三醇0.5％和依托泊洛替诺酯0.5％之间的另一项临床比较研究研究了这些药物在控制白内障手术后炎症中的作用。结论是，在本研究中，酮咯酸与洛替泼诺一样有效。在一项为期4周的巨乳头性结膜炎（GPC）研究中，与安慰剂相比，依托泊酯0.5％乐替泼诺可显着改善GPC的临床体征和症状。在两个治疗组中，眼内压升高（IOP）和其他不良事件的发生率均较低。在两项为期6周的安慰剂对照IAC研究中，依托泊洛特0.2％依托泊特醇的疗效优于安慰剂，并完全缓解了球结膜注射和瘙痒等症状。洛替泼诺依他宝酯的安全性与安慰剂相似。依托泊洛替诺和安慰剂的IOP升高的发生率（定义为压力增加> 10 mmHg）较低。进行了两项关于急性前葡萄膜炎患者的研究，其中将乐替泼诺依替博酯0.5％的疗效和安全性与泼尼松龙1.0％的疗效和安全性进行了比较。在每项研究中，洛替泼诺依他宝酯的疗效均低于泼尼松龙。但是，来自这些研究的综合数据表明，洛匹特那醇依博酯组中高眼压的发生率低于泼尼松龙组。依托泊洛替诺酯治疗IAC和持续性（多年生）变应性结膜炎（PAC）的长期数据的回顾性分析显示，依托泊洛替诺酯≥0.2％治疗至少12个月的患者白内障发生率非常低。这些数据表明依他普罗酯是一种相对于酮皮质类固醇更安全的治疗选择，尤其是用于长达2周的“短暂发作”时。一项安慰剂对照，随机分组，平行分组的单中心研究比较了0.1％盐酸奥洛他定和0.5％酮咯酸氨丁三醇的治疗效果，表明这两种药物均有效缓解IAC的临床症状和体征，即使它们的药理机制不同。但是，奥洛他定在缓解眼部瘙痒方面比酮咯酸更好。在多中心，双掩蔽，随机，平行分组的临床试验中，比较了0.5％酮咯酸三甲胺和左卡巴汀治疗IAC的安全性和有效性。发现在该患者人群中两种治疗均有效且耐受性良好。

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