scholarly journals Treating Allergic Conjunctivitis: A Once-daily Medication that Provides 24-hour Symptom Relief

2016 ◽  
Vol 7 (2) ◽  
pp. ar.2016.7.0158 ◽  
Author(s):  
Warner Carr ◽  
Jack Schaeffer ◽  
Eric Donnenfeld
Keyword(s):  
Mast Cell ◽  
Allergic Conjunctivitis ◽  
Treatment Options ◽  
Symptom Relief ◽  
Unmet Need ◽  
Signs And Symptoms ◽  
Current Treatment ◽  
Duration Of Action ◽  
Once Daily ◽  
Stabilizing Agents

Background Allergic conjunctivitis (AC) is a common ocular inflammatory manifestation of allergen exposure in sensitized individuals. Signs and symptoms of AC can decrease quality of life, interfere with productivity, and lead to considerable economic burden. Consistent suppression of conjunctival inflammation is necessary for managing AC, but currently available medications require frequent administration and exhibit limited duration of action. Methods In this review, we summarized AC pathogenesis, diagnosis, and current treatment options as well as their limitations. Findings from the literature were discussed in the context of the unmet need for a once-daily medication with sustained 24-hour effectiveness. Results Topical pharmacologic treatments are the most common approach for managing extant AC; however, most available medications require multiple daily instillations. Dual-acting antihistamine-mast cell stabilizing agents are currently considered first-line therapeutics for AC because they provide acute relief of signs and symptoms and block persistent inflammation to promote regression of AC. Recent studies of a newly-developed, higher-concentration formulation of a dual-acting antihistamine-mast cell stabilizer have demonstrated that this formulation provides a 24-hour duration of action with once-daily dosing. Conclusions Dual-acting AC medications exhibit a high degree of overall effectiveness and are well tolerated for chronic use. A newly available once-daily medication that manages signs and symptoms of AC for a full 24 hours may be considered a treatment of choice for patients experiencing seasonal or perennial AC. ClinicalTrials.gov NCT01743027 and NCT01479374

scholarly journals A Comparative Study of Efficacy of Alcaftadine 0.25 % and Olopatadine 0.2 % in Allergic Conjunctivitis

2020 ◽  
Vol 7 (52) ◽  
pp. 3153-3158
Author(s):  
Snigdha Sen ◽  
Himanshu Kumar Yadav ◽  
Prerana Singh
Keyword(s):  
Mast Cell ◽  
Inflammatory Mediators ◽  
Severity Score ◽  
Allergic Conjunctivitis ◽  
Late Phase ◽  
Signs And Symptoms ◽  
Once Daily ◽  
Department Of Ophthalmology ◽  
H2 Receptors

BACKGROUND Allergic conjunctivitis is one of the commonly found clinical conditions in ophthalmology practice. Diagnostic features consist of itching, redness and swelling of conjunctiva. Cornea is rarely involved. The physiologic basis of allergy is mast cell degranulation releasing histamine and other pro-inflammatory mediators. Mast cells release histamine which is responsible for early acute phase of allergies and pro-inflammatory mediators like prostaglandins, leukotrienes etc. which are responsible for the late phase. Activation of H1 receptors on conjunctival neurons causes itching while that of H1 and H2 receptors on vascular endothelium is responsible for vasodilation (appearing as redness) and endothelial swelling. Itching and inflammation are caused by response of H4 receptors on immune and inflammatory cells. Olopatadine is an H1 receptor antagonist and mast cell mediator release inhibitor. It is available as 0.1 % formulation used twice daily, and 0.2 % and 0.7 % formulations, both used once daily. Alcaftadine has high affinity and specificity for H1 and H2 receptors, and moderate affinity for the H4 receptors. It is an inverse agonist of H1, H2 and H4 receptors and also acts as mast cell stabiliser. Thus, antihistaminic effect relieves the early phase and mast cell stabilisation relieves the late phase of ocular allergic response. Both have become the most important therapy for allergic conjunctivitis. METHODS This was a prospective, observer-masked, single centre clinical trial conducted at outpatient department of ophthalmology, S.N. Medical College, Agra, from February 2018 to July 2019. Subjects with allergic conjunctivitis (n = 136) were registered for a prospective study and followed up for two weeks. Subjects were randomised using computer generated random number tables into one of the two treatment groups: alcaftadine 0.25 % eye drop and olopatadine 0.2 % eye drop. In this study, efficacy of the drug was taken as mean reduction in severity score of the subjects evaluated at one week and two weeks follow up. RESULTS Patients treated with alcaftadine 0.25 % eye drop showed comparatively early alleviation of signs and symptoms in comparison to patients treated with olopatadine 0.2 % eye drop. Alcaftadine 0.25 % treated subjects experienced significantly higher mean reduction in severity score than olopatadine 0.2 % treated subjects at every follow up visit; after 1 week (p = 0.0205) and after 2 weeks (p = 0.0475). No adverse effects were reported with either drug. CONCLUSIONS Once daily alcaftadine 0.25 % eye drop showed higher efficacy than once daily olopatadine 0.2 % eye drop in relieving signs and symptoms of allergic conjunctivitis at both one week and two weeks follow up. Both treatment arms were found to be safe and effective. KEYWORDS Allergic conjunctivitis, Olopatadine, Alcaftadine

scholarly journals A prospective study of efficacy and safety of olopatadine versus azelastine in allergic conjunctivitis at a tertiary care hospital

2017 ◽  
Vol 6 (8) ◽  
pp. 1948 ◽  
Author(s):  
Jayanthi C. R. ◽  
Nanthini R. ◽  
. Vijayalakshmi
Keyword(s):  
Mast Cell ◽  
Adverse Events ◽  
Allergic Conjunctivitis ◽  
Tertiary Care ◽  
Signs And Symptoms ◽  
Eye Drops ◽  
Care Hospital ◽  
Efficacy And Safety ◽  
H1 Receptor ◽  
Olopatadine Hydrochloride

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.

Eating Disorders. Review Of Current Treatment Options For Anorexia Nervosa, Focused On Psychotherapy And Pharmacological Treatment

2016 ◽  
Vol 33 (S1) ◽  
pp. S432-S432
Author(s):  
B. Sánchez Sánchez ◽  
P. Muñoz-Calero Franco ◽  
N. Rodriguez Criado ◽  
J.F. Cruz Fourcade ◽  
R. Martín Aragón ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Pharmacological Treatment ◽  
Treatment Options ◽  
Signs And Symptoms ◽  
Current Treatment ◽  
Cognitive Behavioral ◽  
Nutritional Rehabilitation ◽  
Clinical Practices ◽  
Major Health Problem ◽  
Competing Interest

IntroductionAnorexia nervosa is a disorder of eating behavior that is a major health problem on our society. It is characterized by three main criteria: self-induced starvation, desire for thinness or fear of obesity, and the presence of medical signs and symptoms due to improper feeding. This work is focused on its treatment. The biopsychosocial approach allows the design and application of effective therapeutic strategies and a multidisciplinary team collaboration is essential.ObjectivesResearch of current pharmacological and psychotherapy treatments options of the disease.Material and methodsLiterature review based on articles and publications on this topic.ResultsIn anorexia nervosa, it is necessary to establish a therapeutic alliance between doctor and patient. Patient usually feels no motivation to improve. The different treatments options to combine, in terms of the patient status, are: nutritional rehabilitation, cognitive-behavioral, family and interpersonal psychotherapies and pharmacological treatment. It can be carried out at the ambulatory, at the day-hospital or by medical stay, even beyond patient will.ConclusionsNowadays, the nutritional rehabilitation is the best treatment established and it is the core treatment. About the psychotherapies, the cognitive-behavioral is the most used because it has exposed better results in all different studies proved and in clinical practices, followed by the family therapy which is the responsible of the patient family's treatment. Pharmacological treatment should not be used systematically and its exclusive use is not enough to resolve anorexia nervosa as there are needed also other treatments combined.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Chronic Constipation: Current Management and Challenges

2011 ◽  
Vol 25 (suppl b) ◽  
pp. 5B-6B ◽  
Author(s):  
Martin Storr
Keyword(s):  
Canadian Journal ◽  
Chronic Constipation ◽  
Initial Treatment ◽  
Unmet Needs ◽  
Treatment Options ◽  
Unmet Need ◽  
Current Treatment ◽  
Current Management ◽  
Novel Drugs ◽  
Canadian Market

Many challenges are associated with the diagnosis and management of patients with chronic constipation. Some of these challenges arise from the currently incomplete understanding of what causes constipation and from the difficulties in diagnosing and classifying the heterogeneous group of patients with chronic constipation. Despite the availability of different treatment options for constipation, an unmet need for drugs in the treatment of patients with chronic constipation remains. This holds especially true for patients who fail an initial treatment. With promising novel drugs either close to approval for the Canadian market or on the horizon, many of these unmet needs may be addressed. The present supplement toThe Canadian Journal of Gastroenterologyprovides an educational overview of the current understanding of the diagnosis, epidemiology, pathophysiology and management of chronic constipation, and summarizes current treatment options in light of current and newly available drugs.

scholarly journals Aneurysms of the petrous internal carotid artery: anatomy, origins, and treatment

2004 ◽  
Vol 17 (5) ◽  
pp. 1-9 ◽  
Author(s):  
James K. Liu ◽  
Oren N. Gottfried ◽  
Amin Amini ◽  
William T. Couldwell
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Wide Spectrum ◽  
Treatment Options ◽  
Signs And Symptoms ◽  
Current Treatment ◽  
Asymptomatic Patients ◽  
Cranial Nerve Palsies ◽  
Close Observation

Aneurysms arising in the petrous segment of the internal carotid artery (ICA) are rare. Although the causes of petrous ICA aneurysms remain unclear, traumatic, infectious, and congenital origins have been implicated in their development. These lesions can be detected incidentally on routine neuroimaging. Patients can also present with a wide spectrum of signs and symptoms, including cranial nerve palsies, Horner syndrome, pulsatile tinnitus, epistaxis, and otorrhagia. The treatment of petrous ICA aneurysms remains challenging. Treatment options include close observation, endovascular therapies, and surgical trapping with or without revascularization. Management dilemmas exist, particularly for incidental lesions found in asymptomatic patients. The authors review the literature and discuss the anatomy of the petrous ICA as well as the pathophysiological features of aneurysms arising in this region, and they propose a management paradigm with current treatment options.

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

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.

scholarly journals Inflammasomes and Proteostasis Novel Molecular Mechanisms Associated With Atrial Fibrillation

2020 ◽  
Vol 127 (1) ◽  
pp. 73-90 ◽  
Author(s):  
Na Li ◽  
Bianca J.J.M. Brundel
Keyword(s):  
Atrial Fibrillation ◽  
Histone Deacetylases ◽  
Molecular Mechanisms ◽  
Treatment Options ◽  
Unmet Need ◽  
Current Treatment ◽  
Cytoskeletal Proteins ◽  
Age Related ◽  
Research Findings ◽  
Shock Proteins

Atrial fibrillation (AF), the most common progressive and age-related cardiac arrhythmia, affects millions of people worldwide. AF is associated with common risk factors, including hypertension, diabetes mellitus, and obesity, and serious complications such as stroke and heart failure. Notably, AF is progressive in nature, and because current treatment options are mainly symptomatic, they have only a moderate effect on prevention of arrhythmia progression. Hereto, there is an urgent unmet need to develop mechanistic treatments directed at root causes of AF. Recent research findings indicate a key role for inflammasomes and derailed proteostasis as root causes of AF. Here, we elaborate on the molecular mechanisms of these 2 emerging key pathways driving the pathogenesis of AF. First the role of NLRP3 (NACHT, LRR, and PYD domains-containing protein 3) inflammasome on AF pathogenesis and cardiomyocyte remodeling is discussed. Then we highlight pathways of proteostasis derailment, including exhaustion of cardioprotective heat shock proteins, disruption of cytoskeletal proteins via histone deacetylases, and the recently discovered DNA damage-induced nicotinamide adenine dinucleotide + depletion to underlie AF. Moreover, potential interactions between the inflammasomes and proteostasis pathways are discussed and possible therapeutic targets within these pathways indicated.

Topical Corticosteroids and Antihistamines—Mast Cell Stabilizers for the Treatment of Allergic Conjunctivitis

2013 ◽  
Vol 06 (02) ◽  
pp. 78
Author(s):  
Lan Gong ◽  
Michael S Blaiss ◽  
◽  
Keyword(s):  
Mast Cell ◽  
Allergic Conjunctivitis ◽  
Clinical Evidence ◽  
Clinical Symptoms ◽  
Treatment Options ◽  
Inflammatory Cells ◽  
Lens Protein ◽  
Loteprednol Etabonate ◽  
Mast Cell Stabilizer ◽  
Inflammatory Drugs

The most common ocular manifestation of allergy, allergic conjunctivitis (AC), is the result of a hypersensitivity response occurring after exposure of the ocular surface to airborne antigens. Treatment options for AC comprise antihistamines, mast cell stabilizers, dual-acting mast cell stabilizer-antihistamines, corticosteroids, nonsteroidal anti-inflammatory drugs (NSAIDs), and combinations thereof. Despite clinical evidence to support the use of antihistamines, such as levocabastine, antihistamines are unable to mitigate all symptoms of AC because histamine is not the only mediator released during the allergic inflammatory response and has no direct effect on inflammatory cells involved in clinical symptoms. Dual-acting mast cell stabilizer-antihistamines, such as bepotastine, alcafatidine, epinastine, ketotifen, and olopatadine, have a broader effect than antihistamines alone. Corticosteroids inhibit the entire inflammatory cascade and therefore offer the most complete option for AC, although their use has been limited due to concerns about increased intraocular pressure (IOP) and the potential for cataract formation with extended use. Loteprednol etabonate (LE) has a decreased effect on IOP and cannot form Schiff base intermediates with lens protein, which is considered a first step in cataractogenesis. The efficacy and safety of LE in the treatment of seasonal AC (SAC) has been demonstrated in clinical trials.

scholarly journals Once-Daily Nevirapine XR

2012 ◽  
Vol 11 (6) ◽  
pp. 369-373 ◽  
Author(s):  
Laveeza Bhatti ◽  
Jay Gladstein
Keyword(s):  
Clinical Trials ◽  
Serum Lipids ◽  
Treatment Guidelines ◽  
Treatment Options ◽  
Transcriptase Inhibitor ◽  
Current Treatment ◽  
Additional Treatment ◽  
Controlled Clinical Trials ◽  
Once Daily ◽  
Randomized Controlled Clinical Trials

Nevirapine (NVP) was the first nonnucleoside reverse transcriptase inhibitor (NNRTI) approved by the US Food and Drug Administration (FDA) in 1996, for the treatment of HIV infection. Current treatment guidelines include NVP as a component of a recommended alternative NNRTI regimen, which may be the preferred regimen for patients with established cardiovascular risk factors since NVP has minimal untoward effects on serum lipids. Two randomized and controlled clinical trials established the noninferior virologic efficacy of twice-daily NVP versus ritonavir-boosted atazanavir (ATV/r), a protease inhibitor with limited effects on serum lipids, each drug on a background regimen of once-daily (QD) tenofovir (TDF)/emtricitabine (FTC). An extended-release (XR) formulation of NVP was developed since QD dosing and reduced pill burdens have been shown to improve regimen adherence. This formulation (Viramune XR 400 mg) was recently FDA approved based on the results of 2 randomized, controlled clinical trials. The XR formulation will provide additional treatment options for patients who may benefit from NVP-based regimens.

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