Efficacy in anterior uveitis of two known steroids and topical tolmetin.

Abstract

SUMMARYWe have compared the anti-inflammatory efficacy of 5% tolmetin sodium dihydrate, 05% prednisolone disodium phosphate, and 0-1% betamethasone disodium phosphate in 71 consecutive patients presenting with acute endogenous non-granulomatous uveitis randomly assigned to one of these treatment groups. Inflammatory symptoms and signs were scored during the course of the 21-day trial period. There was no statistically significant difference in the effect on the signs or symptoms of the three drugs tested. 90% of the Betnesol (betamethasone sodium phosphate, benzalkonium chloride) treated group were clinically judged cured compared with 68% of the Predsol (prednisolone sodium phosphate, benzalkonium chloride) treated group, and 57% of the tolmetin treated group.

Evidence-based, interdisciplinary guidelines for anti-inflammatory treatment of uveitis associated with juvenile idiopathic arthritis

“…Topical corticosteroids High-potency glucocorticoids are more efficacious than low-potency preparations [31][32][33][34][35]; therefore, the high-potency drugs, such as prednisolone acetate 1% or dexamethasone 0.1%, should be used and not the low-potency alternatives, such as rimoxolone (consensus group IIIA). To prevent amblyopia (children under the age of 7 are at high risk), drops should be instilled when the children are awake and ointment applied for the night (consensus group IIIA).…”

“…Two randomized, controlled studies showed that topical treatment using nonsteroidal antiphlogistics was effective, but not as good as topical corticosteroids for treating mild, acute uveitis [34,38,39] (IB). Therefore, treating uveitis attacks with nonsteroidal antiphlogistics alone is not recommended (IB).…”

The role of difluprednate ophthalmic emulsion in clinical practice

“…40 Glucocorticoid gene activation assays have shown betamethasone to be intrinsically stronger than prednisolone, 41 making betamethasone a reference drug when evaluating new corticosteroids for the treatment of ocular inflammation. 42 In an animal model, difluprednate was found to have higher anti-inflammatory activity than betamethasone. 23 Clinical trials have shown that difluprednate is at least comparable to betamethasone in treating postoperative inflammation.…”

Difluprednate 0.05% versus Prednisolone Acetate 1% for Endogenous Anterior Uveitis: Pooled Efficacy Analysis of Two Phase 3 Studies

“…18,19 Other topical steroids shown in previous randomized trials to be effective in the treatment of anterior uveitis are betamethasone phosphate, clobetasone butyrate, hydrocortisone, loteprednol etabonate, and tolmetin sodium dihydrate. [20][21][22][23][24] In other ophthalmic indications, less frequent dosing of topical ophthalmic medications has been reported to be one of the factors associated with better treatment compliance, which may provide an advantage for difluprednate with a four times daily initial therapy label. 9,25 In addition, difluprednate has been reported to have better dose uniformity than branded and generic prednisolone acetate suspensions under various storage conditions.…”