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溴芬酸钠滴眼液 0.07% 每日一次用于白内障手术:两项随机对照试验的结果。

Bromfenac ophthalmic solution 0.07% dosed once daily for cataract surgery: results of 2 randomized controlled trials.

机构信息

Texan Eye, Austin, Texas.

Wolstan Eye Associates, Torrance, California.

出版信息

Ophthalmology. 2014 Jan;121(1):25-33. doi: 10.1016/j.ophtha.2013.07.006. Epub 2013 Sep 8.

Abstract

PURPOSE

To evaluate the efficacy and ocular safety of bromfenac ophthalmic solution 0.07% (Prolensa) dosed once daily for the treatment of ocular inflammation and pain in subjects who underwent cataract surgery with posterior chamber intraocular lens implantation.

DESIGN

Two phase 3, randomized, double-masked, placebo-controlled, multicenter clinical trials.

PARTICIPANTS

Four hundred forty subjects (440 study eyes: 222 in the bromfenac group and 218 in the placebo group).

METHODS

Two phase 3, prospective, randomized, double-masked, placebo-controlled clinical trials were conducted at 39 ophthalmology clinics in the United States. Subjects 18 years of age or older were randomized to receive either bromfenac 0.07% or placebo dosed once daily beginning 1 day before cataract surgery, on the day of surgery, and continuing for 14 days after surgery (for a total of 16 days). Subjects were evaluated on days 1, 3, 8, 15, and 22 after surgery. The primary efficacy end point was cleared ocular inflammation, as measured by the summed ocular inflammation score of zero (anterior chamber cell count = 0 and absence of flare) by day 15. Secondary end points included cleared ocular inflammation at day 15 and the number of subjects who were pain free at day 1. The data from the 2 clinical trials were integrated for analyses.

MAIN OUTCOME MEASURES

Summed ocular inflammation score and ocular pain.

RESULTS

A significantly higher proportion of subjects treated with bromfenac 0.07% achieved complete clearance of ocular inflammation by day 15 and at day 15 compared with placebo (P < 0.0001). A statistically significantly higher proportion of subjects in the bromfenac 0.07% group were pain free at all study visits compared with those in the placebo group (P < 0.0001). Fewer subjects in the bromfenac group (3.2%) discontinued investigational product early because of a lack of efficacy than in the placebo group (23.9%; P < 0.0001). The incidence of adverse events was significantly lower in the bromfenac 0.07% group compared with the placebo group (P = 0.0041).

CONCLUSIONS

Bromfenac ophthalmic solution 0.07% dosed once daily was clinically safe and effective compared with placebo for the treatment of ocular inflammation and pain in subjects who had undergone cataract surgery and may be a beneficial addition to the current standard of care, which commonly includes ophthalmic antibiotics and corticosteroids.

摘要

目的

评估溴芬酸钠滴眼液(普罗纳司) 0.07%(每日一次)治疗行后房型人工晶状体植入白内障手术患者眼部炎症和疼痛的疗效和眼部安全性。

设计

两项 3 期、随机、双盲、安慰剂对照、多中心临床试验。

参与者

440 名受试者(440 只研究眼:溴芬酸钠组 222 只眼,安慰剂组 218 只眼)。

方法

在美国 39 家眼科诊所进行了两项 3 期、前瞻性、随机、双盲、安慰剂对照临床试验。年龄 18 岁或以上的受试者随机接受溴芬酸钠 0.07%或安慰剂治疗,于白内障手术前 1 天、手术当天开始,术后 14 天(共 16 天)每天 1 次。术后第 1、3、8、15 和 22 天对受试者进行评估。主要疗效终点为术后第 15 天用总和眼部炎症评分(前房细胞计数=0 和无闪光)测量的眼部炎症清除率。次要终点包括术后第 15 天的眼部炎症清除率和第 1 天无痛的受试者数量。对 2 项临床试验的数据进行了整合分析。

主要观察指标

总和眼部炎症评分和眼部疼痛。

结果

接受溴芬酸钠 0.07%治疗的受试者在术后第 15 天和第 15 天达到完全清除眼部炎症的比例显著高于安慰剂组(P<0.0001)。在所有研究访视中,接受溴芬酸钠 0.07%治疗的受试者无痛比例显著高于安慰剂组(P<0.0001)。因疗效不佳而提前停止使用研究药物的受试者在溴芬酸钠组(3.2%)明显少于安慰剂组(23.9%;P<0.0001)。与安慰剂组相比,溴芬酸钠 0.07%组的不良事件发生率显著降低(P=0.0041)。

结论

与安慰剂相比,溴芬酸钠滴眼液 0.07% 每日 1 次给药在治疗白内障手术后眼部炎症和疼痛方面具有良好的临床安全性和有效性,可能是目前治疗标准的有益补充,目前的治疗标准通常包括眼科抗生素和皮质类固醇。

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