Efficacy and tolerability comparison of olopatadine, ketotifen, and epinastine in seasonal allergic conjunctivitis: A prospective open-label comparative study

Abstract

Background: Seasonal allergic conjunctivitis (SAC) is the most common allergic disease affecting the eye, with an estimated prevalence of 15–20%. Although sequelae affecting patients’ vision are rare, the symptoms are distressing and may have a significant socioeconomic impact, affecting the quality of life, daily activities, productivity, school performance, etc. The latest generation multiple action topical antiallergic agents such as olopatadine, ketotifen, and epinastine possess antihistaminic, mast cell stabilizing, and anti-inflammatory actions and are now been recommended as the first-line agents in the treatment of SAC. Aims and Objectives: This study aims to compare the efficacy and tolerability of olopatadine, ketotifen, and epinastine in SAC. Materials and Methods: A prospective, comparative study enrolled 90 subjects with SAC. They were randomized into three groups of 30 each, to receive olopatadine, ketotifen, or epinastine. The study medications were instilled into the affected eyes (one/both) twice daily for 4 weeks. The primary outcome measure was changed in clinical parameters of SAC, which was assessed by grading on a 4-point scale (none to severe). The treatment response was monitored during the follow-up visits at 1, 2, 3, and 4 weeks. The tolerability was assessed by monitoring the adverse events (AEs). Results: All the study drugs showed comparable efficacy in reducing conjunctival hyperemia, papillary reaction, and itching. Among them, olopatadine was distinctly more effective than other two drugs at all the visits. Ketotifen and epinastine were equally effective in relieving conjunctival hyperemia, and epinastine was more effective in relieving papillary reaction and ocular itching compared to ketotifen. The study medications showed good tolerability with less severe AEs. Conclusion: In the present study, olopatadine was more effective in relieving symptoms and signs of SAC compared to epinastine and ketotifen.