Meier Edward J, Torkildsen Gail L, Gomes Paul J, Jasek Mark C
Apex Eye, Mason, OH, USA.
Andover Eye, Andover, MA, USA.
Clin Ophthalmol. 2018 Dec 13;12:2617-2628. doi: 10.2147/OPTH.S185835. eCollection 2018.
The purpose of these Phase III studies was to evaluate the efficacy and safety of cetirizine ophthalmic solution 0.24% compared with vehicle in the treatment of allergen-induced conjunctivitis using the Ora conjunctival allergen challenge (CAC) model.
The single-center (Study 1) and multi-center (Study 2), double-masked, randomized, vehicle-controlled, parallel group, CAC studies were conducted over ~5 weeks and four study visits. The study design only differed in entry criteria: Study 2 required more severe allergic conjunctivitis symptoms. Subjects were screened for an allergen response at Visits 1 and 2 and then randomized at Visit 3. Approximately 100 subjects were randomized in each study. The primary efficacy endpoints were ocular itching and conjunctival redness 15 minutes and 8 hours post-treatment, post-CAC.
Cetirizine treatment administered 15 minutes or 8 hours prior to CAC resulted in significantly lower ocular itching at all time points post-CAC (<0.0001) compared to vehicle in both studies. Conjunctival redness measured by the investigator was significantly lower after cetirizine treatment compared to vehicle at 7 minutes post-CAC at both 15 minutes and 8 hours post-treatment in both studies (<0.05). All secondary endpoints were in favor and confirmatory of cetirizine efficacy with significant improvement in chemosis, eyelid swelling, tearing, ciliary redness, and episcleral redness, as well as nasal symptoms (rhinorrhea, nasal pruritus, ear or palatal pruritus, and nasal congestion) post-CAC. The most robust treatment differences were observed in Study 2 where more severe symptoms were required for study entry (<0.05). No safety concerns for cetirizine ophthalmic solution 0.24% were identified.
Cetirizine ophthalmic solution 0.24% was shown to be efficacious in the treatment of ocular and nasal signs and symptoms associated with allergic conjunctivitis and demonstrated a favorable safety profile. Clinical efficacy was demonstrated with a 15-minute onset of action and añ8-hour duration of action.
这些III期研究的目的是使用Ora结膜过敏原激发(CAC)模型,评估0.24%西替利嗪滴眼液与赋形剂相比治疗变应原诱导的结膜炎的疗效和安全性。
单中心(研究1)和多中心(研究2)、双盲、随机、赋形剂对照、平行组、CAC研究进行了约5周,共4次研究访视。研究设计仅在入选标准上有所不同:研究2要求变应性结膜炎症状更严重。在第1次和第2次访视时对受试者进行过敏原反应筛查,然后在第3次访视时随机分组。每项研究中约100名受试者被随机分组。主要疗效终点是治疗后、CAC后15分钟和8小时的眼部瘙痒和结膜充血。
在两项研究中,与赋形剂相比,在CAC前15分钟或8小时给予西替利嗪治疗,在CAC后所有时间点的眼部瘙痒均显著降低(<0.0001)。在两项研究中,治疗后15分钟和8小时,在CAC后7分钟时,研究者测量的结膜充血在西替利嗪治疗后与赋形剂相比显著降低(<0.05)。所有次要终点均支持并证实了西替利嗪的疗效,包括球结膜水肿、眼睑肿胀、流泪、睫状充血和巩膜外层充血以及CAC后的鼻部症状(流涕、鼻痒、耳部或腭部瘙痒和鼻塞)有显著改善。在研究2中观察到最显著的治疗差异,该研究要求入选时症状更严重(<0.05)。未发现0.24%西替利嗪滴眼液有安全性问题。
0.24%西替利嗪滴眼液在治疗与变应性结膜炎相关的眼部和鼻部体征及症状方面显示出疗效,并具有良好的安全性。临床疗效表现为起效15分钟,作用持续8小时。