Allergic conjunctivitis medical therapy: Difference between revisions
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==Overview== | ==Overview== | ||
Treatment of allergic conjunctivitis is by avoiding the allergen (e.g. avoiding grass in bloom during the "hay fever season") and treatment with [[antihistamine]]s, either topical (in the form of [[eye drop]]s), or systemic (in the form of tablets). Antihistamines, medication that stabilizes mast cells, and [[non-steroidal anti-inflammatory drugs]] (NSAIDs) are safe and usually effective. | Treatment of allergic conjunctivitis is by avoiding the allergen (e.g. avoiding grass in bloom during the "hay fever season") and treatment with [[antihistamine]]s, either topical (in the form of [[eye drop]]s), or systemic (in the form of tablets). Antihistamines, medication that stabilizes mast cells, and [[non-steroidal anti-inflammatory drugs]] (NSAIDs) are safe and usually effective. | ||
==Medical Therapy== | ==[[Medical]] [[Therapy]]== | ||
===Dual-Acting [[Antihistamine]]–[[Mast]] [[Cell]] Stabilizing Agents<ref name="pmid27466061">{{cite journal| author=Carr W, Schaeffer J, Donnenfeld E| title=Treating allergic conjunctivitis: A once-daily medication that provides 24-hour symptom relief. | journal=Allergy Rhinol (Providence) | year= 2016 | volume= 7 | issue= 2 | pages= 107-14 | pmid=27466061 | doi=10.2500/ar.2016.7.0158 | pmc=5010431 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27466061 }} </ref>=== | |||
* Inhibits binding of free [[histamine]] to its receptors, thus preventing further release of [[inflammatory]] mediators from [[mast]] [[cells]]. | |||
*Olopatadine, alcaftadine, epinastine, bepotastine besilate are the current first-line agents for acute [[symptomatic]] relief and control of [[inflammation]] and suitable for long-term use. | |||
*Most dual-acting agents require twice-daily dosing<ref name="pmid23998237">{{cite journal| author=Bielory L, Meltzer EO, Nichols KK, Melton R, Thomas RK, Bartlett JD| title=An algorithm for the management of allergic conjunctivitis. | journal=Allergy Asthma Proc | year= 2013 | volume= 34 | issue= 5 | pages= 408-20 | pmid=23998237 | doi=10.2500/aap.2013.34.3695 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23998237 }} </ref>. Olopatadine 0.2%<ref name="pmid18433347">{{cite journal| author=Abelson MB, Gomes PJ| title=Olopatadine 0.2% ophthalmic solution: the first ophthalmic antiallergy agent with once-daily dosing. | journal=Expert Opin Drug Metab Toxicol | year= 2008 | volume= 4 | issue= 4 | pages= 453-61 | pmid=18433347 | doi=10.1517/17425255.4.4.453 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18433347 }} </ref> and alcaftadine<ref name="pmid21339800">{{cite journal| author=Greiner JV, Edwards-Swanson K, Ingerman A| title=Evaluation of alcaftadine 0.25% ophthalmic solution in acute allergic conjunctivitis at 15 minutes and 16 hours after instillation versus placebo and olopatadine 0.1%. | journal=Clin Ophthalmol | year= 2011 | volume= 5 | issue= | pages= 87-93 | pmid=21339800 | doi=10.2147/OPTH.S15379 | pmc=3037035 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21339800 }} </ref> are administered once-daily and maintain effectiveness through 16 hours after administration, as demonstrated in [[conjunctival]] [[allergen]] challenge studies. | |||
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==References== | ==References== | ||
Revision as of 18:04, 29 August 2022
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Treatment of allergic conjunctivitis is by avoiding the allergen (e.g. avoiding grass in bloom during the "hay fever season") and treatment with antihistamines, either topical (in the form of eye drops), or systemic (in the form of tablets). Antihistamines, medication that stabilizes mast cells, and non-steroidal anti-inflammatory drugs (NSAIDs) are safe and usually effective.
Medical Therapy
Dual-Acting Antihistamine–Mast Cell Stabilizing Agents[1]
- Inhibits binding of free histamine to its receptors, thus preventing further release of inflammatory mediators from mast cells.
- Olopatadine, alcaftadine, epinastine, bepotastine besilate are the current first-line agents for acute symptomatic relief and control of inflammation and suitable for long-term use.
- Most dual-acting agents require twice-daily dosing[2]. Olopatadine 0.2%[3] and alcaftadine[4] are administered once-daily and maintain effectiveness through 16 hours after administration, as demonstrated in conjunctival allergen challenge studies.
References
- ↑ Carr W, Schaeffer J, Donnenfeld E (2016). "Treating allergic conjunctivitis: A once-daily medication that provides 24-hour symptom relief". Allergy Rhinol (Providence). 7 (2): 107–14. doi:10.2500/ar.2016.7.0158. PMC 5010431. PMID 27466061.
- ↑ Bielory L, Meltzer EO, Nichols KK, Melton R, Thomas RK, Bartlett JD (2013). "An algorithm for the management of allergic conjunctivitis". Allergy Asthma Proc. 34 (5): 408–20. doi:10.2500/aap.2013.34.3695. PMID 23998237.
- ↑ Abelson MB, Gomes PJ (2008). "Olopatadine 0.2% ophthalmic solution: the first ophthalmic antiallergy agent with once-daily dosing". Expert Opin Drug Metab Toxicol. 4 (4): 453–61. doi:10.1517/17425255.4.4.453. PMID 18433347.
- ↑ Greiner JV, Edwards-Swanson K, Ingerman A (2011). "Evaluation of alcaftadine 0.25% ophthalmic solution in acute allergic conjunctivitis at 15 minutes and 16 hours after instillation versus placebo and olopatadine 0.1%". Clin Ophthalmol. 5: 87–93. doi:10.2147/OPTH.S15379. PMC 3037035. PMID 21339800.