Precision of conjunctival provocation tests in right and left eyes

Aichane, A.; Campbell, Alison M.; Chanal, I.; Richard, Marie Christine; Arnaud, B; Michel, Fran ̧ois-B; Bousquet, Jean

doi:10.1016/0091-6749(93)90036-f

Cited by 44 publications

(20 citation statements)

References 23 publications

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“…The loss of significant effect (p=0.052 vs. p< O.OS) at 10 minutes in the duration of action challenge is probably a reflection of the small sample size. The validity of using this model of ocular allergic disease for the evaluation of drug efficacy, onset and duration of action has been well documented (9)(10)(11)(12)(13).…”

Section: Discussionmentioning

confidence: 99%

The Added Benefit of Local Patanol Therapy When Combined with Systemic Claritin for the Inhibition of Ocular Itching in the Conjunctival Antigen Challenge Model*

Abelson¹,

Lanier²

1999

Acta Ophthalmologica Scandinavica

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ABSTRACT.Background: Allergic conjunctivitis very often occurs simultaneously with rhinitis in seasonal allergy sufferers. While systemic anti-allergic and antihistaminic agents are effective against many signs and symptoms of allergy, they may not adequately control ocular signs and symptoms in patients with multiple target organ hypersensitivity. Patanol® (olopatadine hydrochloride 0.1% ophthalmic solution, Alcon Laboratories, Inc., Fort Worth, TX), a new effective anti-allergic mast cell stabilizer with antihistaminic properties, is approved for the prevention of ocular itching due to allergic conjunctivitis. Objective: To determine whether Patanol in combination with the systemic antihistamine Claritin® (loratadine, Schering, Kenilworth, NJ) reduces the ocular itching associated with allergic conjunctivitis more effectively than Claritin alone. A topical ocular antigen challenge induced the allergic conjunctivitis in 15 subjects. Methods: This was a randomized, doublemasked study in which the contralateral eye served as the control. On Visit 1, an allergen dose which elicited response scores > 2 for ocular itching was identified.Itching was graded by the subject using a 0 to 4 point scale. At Visit 2, the threshold allergen concentration was confirmed. At Visit 3, the onset of action challenge, in addition to Claritin (10 mg tablet), each subject received Patanol in one eye and placebo in the fellow eye in a randomized, double-masked fashion. Allergen was instilled one hour after dosing, and ocular itching was graded at 3, 7, 10 and 20 minutes after challenge. At Visit 4, the duration of action challenge, the same drug regimen was followed as in Visit 3. However, allergen challenge was performed eight hours after dosing, and itching graded after 3, 7, 10 and 20 minutes. Results: Patient eyes treated with Patanol were significantly less itchy than those treated with systemic Claritin alone at critical time points 3, 7, and 10 minutes after the onset of action challenge (p< O.OS), and at 3 and 7 minutes after the duration of action challenge (p< O.OS). Conclusion: The addition of topical Patanol to systemic Claritin therapy significantly reduced ocular itching associated with allergic conjunctivitis compared to treatment with Claritin alone. These findings prove the added benefit of local P atanol therapy in the treatment of ocular allergic symptoms in patients receiving systemic antihistamines for concomitant systemic allergies.

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Section: Discussionmentioning

confidence: 99%

The Added Benefit of Local Patanol Therapy When Combined with Systemic Claritin for the Inhibition of Ocular Itching in the Conjunctival Antigen Challenge Model*

Abelson¹,

Lanier²

1999

Acta Ophthalmologica Scandinavica

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“…CAC testing requires provocative inoculation of eyes with increasing allergenic inoculations, assessing for allergic responses, and then evaluating ocular responses to trial medications (Abelson et al 1990). CAC testing provides highly reproducible results and has been used frequently when studying groups of human ocular allergies (Friedlaender 2004), although questions remain regarding individual responses (Aichane et al 1993) and use of rescue medications and quality of life issues (Radcliff et al 2006). Few clinicians have direct clinical experience with CAC testing and may be left with lingering questions regarding the generalised applicability of CAC testing and the results of such trials.…”

Section: Patient Recruitmentmentioning

confidence: 99%

Potential bias in ophthalmic pharmaceutical clinical trials

Varner¹

2008

OPTH

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To make clinicians aware of potential sources of error in ophthalmic pharmaceutical clinical trials that can lead to erroneous interpretation of results, a critical review of the study design of various pharmaceutical ophthalmic clinical trials was completed. Discrepancies as a result of study shortcomings may explain observed differences between reported ophthalmic trial data and observed clinical results.

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“…For example, ocular allergen challenge results in release of tryptase, leukotriene C 4 (LTC 4 ), and prostaglandin D 2 (PGD 2 ) in tears of allergic, but not in non-allergic patients [21][22][23][24]. Mechanical provocation can also result in mast cell activation.…”

Section: Mast Cell Mediators and Ocular Allergymentioning

confidence: 99%

Mechanisms of Antihistamines and Mast Cell Stabilizers in Ocular Allergic Inflammation

Cook¹,

Stahl²,

Graziano³

2002

CDTIA

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Mast cells play a central role in allergic reactions and inflammation. Successful anti-allergic therapies have typically targeted mast cell mediators, particularly histamine. Antihistaminic compounds interact with the various histamine receptors found on many cells, whereas other compounds such as disodium cromoglycate, are referred to as mast cell stabilizers, as they inhibit degranulation. Some of the most successful compounds developed recently are dual-action, in that they have both anti-histaminic and mast cell stabilizing activities. Recent trends in pharmaceutical intervention, however, have been focused on the secondary effects of mast cell mediators on epithelial cell adhesion molecule expression and mediator release in the process of allergic inflammation. Since, the ocular mucosa is highly exposed to environmental allergens it is commonly involved in allergic reactions and, as such, has been a useful and accessible model in which to test new therapies in vivo. These ocular allergen provocation studies permit analysis of ocular surface cells and evaluation of tear film mediators. Furthermore, techniques to purify conjunctival mast cells have facilitated the study of the effects of mast cell stabilizing compounds on other mast cell mediators, such as cytokines, and the direct effects of mast cell mediators on epithelial cells in vitro. This review will discuss current understanding of how anti-histamines and mast cell stabilizers work, particularly in the context of molecular mechanisms of ocular allergic inflammation.

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Precision of conjunctival provocation tests in right and left eyes

Cited by 44 publications

References 23 publications

The Added Benefit of Local Patanol Therapy When Combined with Systemic Claritin for the Inhibition of Ocular Itching in the Conjunctival Antigen Challenge Model*

The Added Benefit of Local Patanol Therapy When Combined with Systemic Claritin for the Inhibition of Ocular Itching in the Conjunctival Antigen Challenge Model*

Potential bias in ophthalmic pharmaceutical clinical trials

Mechanisms of Antihistamines and Mast Cell Stabilizers in Ocular Allergic Inflammation

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