Reproxalap Improves Signs and Symptoms of Allergic Conjunctivitis in an Allergen Chamber: A Real-World Model of Allergen Exposure

Background: Allergic conjunctivitis, an ocular surface inflammatory disease with significant social and economic impact affects approximately 25% of the general population. H1 receptor blockers, mast cell stabilizers and drugs that block cytokine and prostaglandin formation form the treatment armamentarium. Olopatadine hydrochloride and Azelastine hydrochloride are dual-acting selective H1 receptor antagonist with mast-cell stabilizing property. This study was undertaken to assess the efficacy and safety of olopatadine hydrochloride 0.1% and Azelastine hydrochloride 0.05% in allergic conjunctivitis amongst Indians.Methods: After obtaining Institutional Ethics Committee approval and written informed consent, 120 patients diagnosed with allergic conjunctivitis fulfilling the inclusion/exclusion criteria were enrolled in the study. Study was done from April 2014 to June 2015 at Minto eye hospital. Study subjects were treated with olopatadine hydrochloride 0.1% and Azelastine hydrochloride 0.05% eye drops BD for 15 days. Ocular symptoms, instead of and signs and adverse events, if any were recorded on the day 8 and day 15 follow up visits.Results: At the end of the study period, the reduction in the ocular itching score from baseline was higher in the olopatadine group compared to the azelastine group (p<0.002). Similarly, the scores of ocular congestion (p<0.008), foreign body sensation (p<0.009), tearing (p<0.001), erythema (p<0.002) and chemosis (p<0.015) also showed larger reduction in the olopatadine treated patients. The common adverse events encountered in both the groups were stinging after instillation, burning, bitter taste and headache.Conclusions: In allergic conjunctivitis, both olopatadine and azelastine were found to be effective in relieving ocular signs and symptoms, but olopatadine was found to be superior in terms of efficacy, safety and tolerability with minimal side effects.

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Comparison of Topical 0.05% Levocabastine and 0.1% Lodoxamide in Patients with Allergic Conjunctivitis

European Journal of Ophthalmology ◽

10.1177/112067219800800402 ◽

1998 ◽

Vol 8 (4) ◽

pp. 207-216 ◽

Cited By ~ 12

Author(s):

C. Richard ◽

C. Trinquand ◽

E. Bloch-Michel ◽

F. Favennec ◽

L. Helleboid ◽

...

Keyword(s):

Allergic Conjunctivitis ◽

Ophthalmic Solution ◽

Signs And Symptoms ◽

Serious Adverse Events ◽

Treatment Groups ◽

Self Evaluation ◽

Eyelid Edema ◽

Parallel Group ◽

Clinically Significant ◽

Allergy Symptom

Purpose The aim of the study was to assess the efficacy and safety of 0.05% levocabastine eyedrops (H1 receptor blocker given BID + vehicle BID) compared with 0.1% lodoxamide ophthalmic solution (mast-cell stabilizer instilled QID) in reducing ocular signs and symptoms of allergic conjunctivitis. Methods A randomized, double-masked, parallel-group study was conducted in seven centres in France, in which 93 patients suffering from seasonal or perennial allergic conjunctivitis were randomly allocated to either 0.05% levocabastine (n = 47) or 0.1% lodoxamide (n = 46) in both eyes for a 14-day period. Efficacy was evaluated by subjective (prickling, burning, photophobia, itching) and objective (redness, chemosis, eyelid edema, tearing) sign scores at visits on days 7 and 14, and from data noted daily by the patient in a self-evaluation form. Safety was assessed as tolerance upon instillation and adverse event reports. Results The ocular allergy symptom and sign scores were comparable in the two treatment groups at baseline. With time, statistically and clinically significant reductions (p < 0.001) from baseline were observed for the subjective and objective scores, with no difference between the treatment groups. After the first instillation, signs were alleviated more rapidly in levocabastine-treated patients than in the lodoxamide group (p < 0.001). Overall assessments by the patient and investigator were similar in both groups. No serious adverse events were reported. Conclusions Levocabastine ophthalmic suspension 0.05% (BID) appears to be as effective and safe as lodoxamide 0.1% (QID) in the management of allergic conjunctivitis.

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The Educators Coop: A virtual world model for real world collaboration

Proceedings of the American Society for Information Science and Technology ◽

10.1002/meet.2008.1450450382 ◽

2008 ◽

Vol 45 (1) ◽

pp. 1-10 ◽

Cited By ~ 1

Author(s):

Leslie Jarmon ◽

Joe Sanchez

Keyword(s):

Real World ◽

Virtual World ◽

World Model

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How to observe real-world events through a distributed world model

Proceedings. Tenth International Conference on Parallel and Distributed Systems, 2004. ICPADS 2004. ◽

10.1109/icpads.2004.1316128 ◽

2004 ◽

Cited By ~ 2

Author(s):

M. Bauer ◽

K. Rothermel

Keyword(s):

Real World ◽

World Model

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Comparison of efficacy of topical alcaftadine (0.25%) versus olopatadine (0.1%) in allergic conjunctivitis

Indian Journal of Clinical and Experimental Ophthalmology ◽

10.18231/j.ijceo.2021.126 ◽

2022 ◽

Vol 7 (4) ◽

pp. 630-633

Author(s):

Kiran Kumar L ◽

M S Smitha Gowda

Keyword(s):

Allergic Conjunctivitis ◽

Treatment Options ◽

Signs And Symptoms ◽

Outcome Variable ◽

Eye Drops ◽

Open Label ◽

Parallel Group ◽

Significant Efficacy ◽

Group B ◽

Olopatadine Hydrochloride

The most common atopic ocular condition in clinical practice is allergic conjunctivitis. One of the preferred treatment options for allergic Conjunctivitis is anti histamines eye drops. The study purpose is to compare the clinical efficacy between topical alcaftadine 0.25% and olopatadine hydrochloride 0.1% in allergic conjunctivitis patients.A prospective, randomized, open label, parallel group, comparative study was conducted on 60 Patients with bilateral allergic conjunctivitis (30 in each group) after taking an informed written consentand was evaluated from May 2018 to November 2018. Patients were randomized into 2 groups of 30 each, group A received topical Alcaftadine 0.25% twice daily and patients in Group B received topical olopatadine hydrochloride 0.1% twice daily for 2 weeks. The patients were evaluated on first visit (baseline) followed by 7 and 14 day after starting the treatment. At each visit signs and symptoms were evaluated and rated using a scale from 0-3(0-Absent, 1- mild, 2 moderate and 3- severe). The change from baseline in the mean scores of itching, hyperemia, photophobia and tearing on day 14 is the primary outcome variable.: The signs and symptoms of allergic conjunctivitis were reduced by 2 weeks from baseline after using both the drugs. Relative significant efficacy was achieved in alcaftadine group for Itching, hyperemia and photophobia, but not for tearing (p=0.3). When compared to 0.1% olopatadine hydrochloride, 0.25% alcaftadine is more effective in reducing the symptoms of all types of allergic conjunctivitis except those mentioned in exclusion criteria.

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Think-aloud study about the diagnosis of chronic heart failure in Belgian general practice

BMJ Open ◽

10.1136/bmjopen-2018-025922 ◽

2019 ◽

Vol 9 (3) ◽

pp. e025922 ◽

Cited By ~ 2

Author(s):

Miek Smeets ◽

Pieter De Witte ◽

Sanne Peters ◽

Bert Aertgeerts ◽

Stefan Janssens ◽

...

Keyword(s):

Heart Failure ◽

General Practice ◽

Chronic Heart Failure ◽

Natriuretic Peptide ◽

Real World ◽

Signs And Symptoms ◽

Diagnostic Reasoning ◽

Added Value ◽

Diagnostic Model ◽

Think Aloud

ObjectivesDiagnosing chronic heart failure (CHF) in general practice is challenging. Our aim was to investigate how general practitioners (GPs) diagnose CHF in real-world patients.DesignThink-aloud study.MethodsFourteen GPs were asked to reason about four real-world CHF cases from their own practices. The cases were selected through a clinical audit. This was followed by an interview to get a deeper insight in their reasoning. The Qualitative Analysis Guide of Leuven was used as a guide in data analysis.ResultsWe developed a conceptual diagnostic model based on three important reasoning steps. First, GPs assessed the likelihood of CHF based on the presence or absence of HF signs and symptoms. However, this approach had serious limitations since GPs experienced many barriers in their clinical assessment, especially in comorbid elderly. Second, if CHF was considered based on step 1, the main influencing factor to take further diagnostic steps was the GPs’ perception of the added value of a validated CHF diagnosis in that specific case. Third, the choice and implications of these further diagnostic steps (N-terminal pro B-type natriuretic peptide, ECG and/or cardiac ultrasound) were influenced by the GPs’ knowledge about these tests and the quality of the cardiologists’ reports.ConclusionThis think-aloud study identified the factors that influenced the diagnostic reasoning about CHF in general practice. As a consequence, targets to improve this diagnostic reasoning were withheld: a paradigm shift towards an earlier and more comprehensive risk assessment with, among others, access to natriuretic peptide testing and convincing GPs of the added value of a validated HF diagnosis.

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Real-World Model In The Hull{White Model

Interest Rate Modeling for Risk Management: Market Price of Interest Rate Risk - Economics: Current and Future Developments (2nd Edition) ◽

10.2174/9781681086897118010011 ◽

2018 ◽

pp. 175-194

Author(s):

Takashi Yasuoka

Keyword(s):

Real World ◽

World Model

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Omalizumab for Severe Asthma: Beyond Allergic Asthma

BioMed Research International ◽

10.1155/2018/3254094 ◽

2018 ◽

Vol 2018 ◽

pp. 1-10 ◽

Cited By ~ 6

Author(s):

C. C. Loureiro ◽

L. Amaral ◽

J. A. Ferreira ◽

R. Lima ◽

C. Pardal ◽

...

Keyword(s):

Allergic Asthma ◽

Severe Asthma ◽

Clinical Signs ◽

Signs And Symptoms ◽

Allergen Exposure ◽

Response To Therapy ◽

Double Blind ◽

Clinical Signs And Symptoms ◽

Underlying Mechanisms

Different subsets of asthma patients may be recognized according to the exposure trigger and the frequency and severity of clinical signs and symptoms. Regarding the exposure trigger, generally asthma can be classified as allergic (or atopic) and nonallergic (or nonatopic). Allergic and nonallergic asthma are distinguished by the presence or absence of clinical allergic reaction and in vitro IgE response to specific aeroallergens. The mechanisms of allergic asthma have been extensively studied with major advances in the last two decades. Nonallergic asthma is characterized by its apparent independence from allergen exposure and sensitization and a higher degree of severity, but little is known regarding the underlying mechanisms. Clinically, allergic and nonallergic asthma are virtually indistinguishable in exacerbations, although exacerbation following allergen exposure is typical of allergic asthma. Although they both show several distinct clinical phenotypes and different biomarkers, there are no ideal biomarkers to stratify asthma phenotypes and guide therapy in clinical practice. Nevertheless, some biomarkers may be helpful to select subsets of atopic patients which might benefit from biologic agents, such as omalizumab. Patients with severe asthma, uncontrolled besides optimal treatment, notwithstanding nonatopic, may also benefit from omalizumab therapy, although currently there are no randomized double-blind placebo controlled clinical trials to support this suggestion. However, omalizumab discontinuation according to each patient’s response to therapy and pharmacoeconomical analysis are questions that remain to be answered.

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