1
|
Chen C, Wang C, Zhou X, Xu L, Chen H, Qian K, Jia B, Su G, Fu J. Nonsteroidal anti-inflammatory drugs for retinal neurodegenerative diseases. Prostaglandins Other Lipid Mediat 2021; 156:106578. [PMID: 34245897 DOI: 10.1016/j.prostaglandins.2021.106578] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 06/29/2021] [Accepted: 07/06/2021] [Indexed: 10/20/2022]
Abstract
Nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most common prescription drugs for inflammation, and topical NSAIDs are often used in ophthalmology to reduce pain, photophobia, inflammation, and edema. In recent years, many published reports have found that NSAIDs play an important role in the treatment of retinal neurodegenerative diseases, such as age-related macular degeneration (AMD), diabetic retinopathy (DR), glaucoma, pathological myopia, and retinitis pigmentosa (RP). The aim of the current review is to provide an overview of the role of various NSAIDs in the treatment of retinal neurodegenerative diseases and the corresponding mechanisms of action. This review highlighted that the topical application of NSAIDs for the treatment of retinal degenerative diseases has been studied to a remarkable extent and that its beneficial effects in many diseases have been proven. In the future, prospective studies with large study populations are required to extend these effects to clinical settings.
Collapse
Affiliation(s)
- Chen Chen
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun, Jilin, China.
| | - Chenguang Wang
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun, Jilin, China.
| | - Xuebin Zhou
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun, Jilin, China.
| | - Lingxian Xu
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun, Jilin, China.
| | - Han Chen
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun, Jilin, China.
| | - Kun Qian
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun, Jilin, China.
| | - Bo Jia
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun, Jilin, China.
| | - Guanfang Su
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun, Jilin, China.
| | - Jinling Fu
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun, Jilin, China.
| |
Collapse
|
2
|
Comparative evaluation of once-daily and twice-daily dosing of topical bromfenac 0.09%: aqueous pharmacokinetics and clinical efficacy study. J Cataract Refract Surg 2021; 47:1115-1121. [PMID: 34468447 DOI: 10.1097/j.jcrs.0000000000000589] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 01/14/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate aqueous pharmacokinetics of topical bromfenac 0.09% and compare clinical outcomes of once- and twice-daily dosing in phacoemulsification. SETTING Dr. R.P. Center for Ophthalmic Sciences, AIIMS, New Delhi, India. DESIGN Prospective interventional study. METHODS In phase I, single-drop aqueous pharmacokinetics of topical bromfenac was estimated at 15 minutes, 30 minutes, 1 hour, 2 hours, 4 hours, 12 hours, and 24 hours using liquid chromatography mass spectrometry in 60 eyes. In phase II, 45 eyes undergoing phacoemulsification were enrolled: group I (control, n = 15), group II (once-daily bromfenac, n = 14), and group III (twice-daily bromfenac, n = 16). Intraoperative pupillary miosis, postoperative anterior chamber (AC) flare, Summed Ocular Inflammation Score (SOIS), central macular thickness (CMT), and pain scores were assessed. Follow-up was performed at 1 day, 7 days, 28 days, and 90 days postoperatively. RESULTS Half-life of topical bromfenac was 3.6 hours, mean residence time 5.5 hours, and peak concentration (63.73 ng/mL) achieved after 2 hours. Aqueous concentration was more than inhibitory concentration (IC50) at 12 hours but not at 24 hours. Cumulative effect was observed with repeated dosing with aqueous levels more than IC50 in once-daily and twice-daily groups at 5 days. Significant intraoperative miosis was observed in group I. Pain score, AC flare, and SOIS were significantly more in group I (P < .001) and comparable in groups II and III at all timepoints. CMT was comparable in all groups; no case developed cystoid macular edema. CONCLUSIONS Single-dose topical bromfenac did not maintain therapeutic aqueous concentration over 24 hours; however, cumulative effect was observed with repeated dosing. Clinical efficacy of once-daily and twice-daily dosing was comparable.
Collapse
|
3
|
Song SH, Baek SK, Lee MW, Lee YH. Effect of 0.1% Bromfenac for Preventing Macular Edema after Cataract Surgery in Patients with Diabetes. KOREAN JOURNAL OF OPHTHALMOLOGY 2020; 34:46-55. [PMID: 32037749 PMCID: PMC7010466 DOI: 10.3341/kjo.2019.0044] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 09/30/2019] [Accepted: 10/08/2019] [Indexed: 12/03/2022] Open
Abstract
Purpose To investigate the effect of 0.1% bromfenac sodium hydrate ophthalmic solution for prevention of macular edema after cataract surgery in patients with diabetes. Methods A retrospective analysis of 75 patients with diabetes who underwent cataract surgery was performed. Thirty-eight patients (52 eyes) were instilled with 0.1% bromfenac solution (bromfenac group) and 37 patients (46 eyes) were not (control group). Results There were no significant preoperative between-group differences. Compared to the control group, at 1 month after surgery, the bromfenac group showed slightly better best-corrected visual acuity (0.12 ± 0.12 vs. 0.32 ± 0.42, p = 0.142), lower central macular thickness (265.58 ± 31.28 vs. 314.15 ± 76.11 µm, p < 0.001), and lower macular volume (8.46 ± 0.60 vs. 9.14 ± 1.53 mm3, p = 0.022). There were no significant differences between the two groups at 4 and 6 months postoperatively (p > 0.05). Mean changes in central macular thickness showed significant differences at 1 and 4 months postoperatively (−1.44 ± 11.72 and 10.44 ± 22.48 µm in bromfenac group vs. 47.19 ± 70.24 and 31.69 ± 48.04 µm in control group, p < 0.001 and p = 0.016) and mean changes in macular volume showed a significant difference at 1 month postoperatively (−0.08 ± 0.47 mm3 in bromfenac group vs. 0.58 ± 1.28 mm3 in control group, p < 0.001). There were no significant differences thereafter (p > 0.05). Conclusions Treatment with 0.1% bromfenac sodium hydrate ophthalmic solution showed good efficacy for preventing cystoid macular edema early after cataract surgery in patients with diabetes.
Collapse
Affiliation(s)
- Seok Hyeon Song
- Department of Ophthalmology, Konyang University College of Medicine, Daejeon, Korea
| | - Seung Kook Baek
- Department of Ophthalmology, Konyang University College of Medicine, Daejeon, Korea
| | - Min Woo Lee
- Department of Ophthalmology, Konyang University College of Medicine, Daejeon, Korea
| | - Young Hoon Lee
- Department of Ophthalmology, Konyang University College of Medicine, Daejeon, Korea.
| |
Collapse
|
4
|
Yun JM, Cho YW, Moon JW. Bromfenac as Adjunctive Treatment with Intravitreal Bevacizumab in Branch Retinal Vein Occlusion of Macular Edema. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2020. [DOI: 10.3341/jkos.2020.61.2.183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Jong Myoung Yun
- Department of Ophthalmology, Daegu Fatima Hospital, Daegu, Korea
| | - Young Wook Cho
- Department of Ophthalmology, Daegu Fatima Hospital, Daegu, Korea
| | - Jong Won Moon
- Department of Ophthalmology, Daegu Fatima Hospital, Daegu, Korea
| |
Collapse
|
5
|
Schechter BA. Use of topical bromfenac for treating ocular pain and inflammation beyond cataract surgery: a review of published studies. Clin Ophthalmol 2019; 13:1439-1460. [PMID: 31534309 PMCID: PMC6682171 DOI: 10.2147/opth.s208700] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 06/27/2019] [Indexed: 01/20/2023] Open
Abstract
Topical ophthalmic nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used to treat postoperative inflammation and pain following cataract surgery and for treatment and prophylaxis of pseudophakic cystoid macular edema (CME). Bromfenac is a brominated NSAID with strong in vitro anti-inflammatory potency. Like other ophthalmic NSAIDs, bromfenac is often used outside of the cataract surgery setting. This paper provides an overview of bromfenac’s preclinical ocular pharmacology and pharmacokinetics, followed by a review of 23 published clinical studies in which various marketed bromfenac formulations were used for conditions other than cataract surgery or pseudophakic CME. These include: post-refractive eye surgery; macular edema associated with diabetes, uveitis, or retinal vein occlusion; inflammation associated with age-related macular degeneration; pain related to intravitreal injections; and other ocular anterior segment and surface disorders with an inflammatory component. The published evidence reviewed supports the safety and effectiveness of bromfenac in these additional ophthalmic indications. Bromfenac was well tolerated when given alone or in combination with intravitreal anti-vascular endothelial growth factor agents, topical corticosteroids, or topical mast-cell stabilizers. The most common adverse event reported was ocular irritation. No serious adverse events (ie, corneal epithelial disorders) were reported, although the majority of studies did not systematically evaluate potential side effects. Corneal complications, such as melts reported with diclofenac and ketorolac, were not observed with bromfenac in the studies. In summary, published study data support the clinical utility of bromfenac in various ocular disorders beyond post-cataract surgery. Additional studies are warranted to further define the potential role of bromfenac ophthalmic solution in clinical practice.
Collapse
Affiliation(s)
- Barry A Schechter
- Cornea and Cataract Service, Florida Eye Microsurgical Institute, Boynton Beach, FL, USA
| |
Collapse
|
6
|
Topical bromfenac transiently delays axotomy-induced retinal ganglion cell loss. Exp Eye Res 2019; 182:156-159. [PMID: 30940447 DOI: 10.1016/j.exer.2019.03.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 03/11/2019] [Accepted: 03/29/2019] [Indexed: 11/21/2022]
Abstract
Optic nerve axotomy in rodents allows detailed studies of the effect of different treatments on the survival of central nervous system neurons, the retinal ganglion cells (RGCs). Here we have analyzed the neuroprotective effect of topical bromfenac treatment, a nonsteroidal anti-inflammatory drug (NSAID) used in clinic to ameliorate post-operative inflammation, on axotomized rat RGCs. The left optic nerve of adult rats was subjected to optic nerve crush (ONC). Half of the rats were treated with a topical instillation of saline. On the other half, immediately after the surgery, 2 drops of bromfenac (0.09% Yellox; Bausch & Lomb) were instilled, and then every 12 h until analysis. Retinas in both groups were dissected 3, 5, 7, 9 and 14 days after ONC (n = 4-8/time point/group). Toxicity of bromfenac was assessed in intact retinas treated during 14 days (n = 6). Intact untreated retinas were used as control of the RGC population. RGCs were identified by Brn3a immunodetection and automatically quantified. Our results show that bromfenac does not cause RGC loss in intact retinas. In the injured groups, the number of RGCs at 7, 9 and 14 days after the lesion was significantly higher in treated vs. untreated retinas. To our knowledge this is the first report showing that a topical treatment with a NSAIDs delays axotomy-induced RGC loss and indicates that treatment with NSAIDs could be used as conjunctive therapy in diseases that proceed with optic nerve damage.
Collapse
|
7
|
Sheppard JD, Cockrum PC, Justice A, Jasek MC. In Vivo Pharmacokinetics of Bromfenac Ophthalmic Solution 0.075%, Bromfenac Ophthalmic Solution 0.07%, and Nepafenac/Amfenac Ophthalmic Suspension 0.3% in Rabbits. Ophthalmol Ther 2018; 7:157-165. [PMID: 29761367 PMCID: PMC5997598 DOI: 10.1007/s40123-018-0130-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Indexed: 01/07/2023] Open
Abstract
Introduction Little is known of the ocular distribution characteristics of currently branded non-steroidal anti-inflammatory drugs (NSAIDs) in the United States. This study was designed to predict the ocular bioavailability characteristics in humans using Dutch Belted rabbits as a surrogate. Commercially available, topically-applied NSAIDs containing bromfenac or nepafenac/amfenac were evaluated. Methods 126 healthy adult Dutch Belted rabbits were randomly assigned to three treatment cohorts (BromSite® twice daily [BID] in the right eye, BromSite® once daily [QD] in the right eye, Prolensa® QD in the right eye and Ilevro™ QD in the left eye) and 7 post-dosing time points (0.5, 1, 2, 4, 8, 12, 24 h after final instillation). The study eyes received 40 µL of the assigned drug for a consecutive 9 days. Samples of aqueous humor, iris-ciliary body, choroid, sclera, and retina were harvested from the study eyes at the assigned time point after the last dose on the 9th day. NSAID content in ocular tissues was analyzed using high-performance liquid chromatography (HPLC), and area under the curve (AUC0.5–24h), maximum concentration (Cmax), and time to maximum concentration (Tmax) were determined. Results Peak NSAID concentrations were reached within 1–3 h in the anterior segment and within 1–3 h in the posterior segment after last dose. Throughout the ocular tissues, both AUC and Cmax for BromSite® (BID and QD) were consistently higher than respective NSAID concentrations of Prolensa® QD and Ilevro® QD. When comparing BromSite® BID to QD, the BID regimen produced generally higher but statistically similar bromfenac concentrations throughout the ocular tissues except in the aqueous humor and iris-ciliary body, where the AUC BID was statistically significantly higher with BromSite® BID. Conclusion As a surrogate to human ocular bioavailability, BromSite® demonstrated significantly greater NSAID compared to Prolensa® QD and Ilevro® QD. The DuraSite® component of BromSite® appears to enhance ocular penetration throughout both anterior and posterior tissues. Funding Sun Pharmaceutical Industries Ltd.
Collapse
Affiliation(s)
| | | | | | - Mark C Jasek
- Sun Pharmaceutical Industries, Inc., Princeton, NJ, USA
| |
Collapse
|
8
|
Combinatorial treatment with topical NSAIDs and anti-VEGF for age-related macular degeneration, a meta-analysis. PLoS One 2017; 12:e0184998. [PMID: 28985220 PMCID: PMC5630133 DOI: 10.1371/journal.pone.0184998] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 09/05/2017] [Indexed: 11/19/2022] Open
Abstract
Inflammation is a key pathogenic factor in age-related macular degeneration (AMD). However, the clinical importance of combining anti-VEGF agents and topical NSAIDs to reduce inflammation remains unclear. In this study, we systematically reviewed clinical trials comparing combined treatment versus anti-VEGF alone in AMD patients. We quantified treatment effects via meta-analysis. The pooled weighted mean difference (WMD, -0.91, 95%CI: -1.39 to -0.42, P = 0.0003) demonstrates that combined treatment may reduce required anti-VEGF injection number, probably by means of decreasing central retina thickness (CRT) (WMD = -22.9, 95% CI: -41.20 to -4.59, P = 0.01). The best corrected visual acuity (BCVA) did not change significantly between these two groups (WMD = - 0.01, 95%CI: -0.23 to 0.20, P = 0.90). Topical NSAIDs slightly increased the incidence of foreign body sensation (Odds Ratio [OR] = 2.63, 95%Cl: 1.06 to 6.52, P = 0.76). Combining topical NSAIDs and anti-VEGF agents may provide a new strategy for AMD treatment.
Collapse
|
9
|
Chen H, Lin H, Chen W, Zhang B, Xiang W, Li J, Chen W. Topical 0.1% Bromfenac Sodium for Intraoperative Miosis Prevention and Prostaglandin E2 Inhibition in Femtosecond Laser-Assisted Cataract Surgery. J Ocul Pharmacol Ther 2017; 33:193-201. [DOI: 10.1089/jop.2016.0114] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Hui Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Haotian Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Wan Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Bo Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Wu Xiang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Jing Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Weirong Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| |
Collapse
|
10
|
Sheppard JD. Topical bromfenac for prevention and treatment of cystoid macular edema following cataract surgery: a review. Clin Ophthalmol 2016; 10:2099-2111. [PMID: 27822006 PMCID: PMC5087782 DOI: 10.2147/opth.s86971] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Topical nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids, alone or in combination, have historically been used off label in the US to prevent and treat postoperative cystoid macular edema (CME). This literature review presents available data on the use of bromfenac 0.07% or 0.09% to prevent and treat CME following cataract surgery. Bromfenac is an NSAID approved to treat postoperative inflammation and reduce ocular pain following cataract surgery. Few cases of clinical CME were observed with bromfenac use in a total of 19 reviewed studies. There were no significant differences in CME incidence between bromfenac and corticosteroid-treated patients or between bromfenac- and bromfenac plus corticosteroid-treated patients. Bromfenac demonstrated comparable efficacy to other NSAIDs in preventing CME. Compared with corticosteroids, bromfenac alone or plus a corticosteroid showed similar or better efficacy in minimizing changes in retinal thickness and macular volume. In diabetic cataract surgery patients, bromfenac was comparable or superior to corticosteroids for minimizing changes in retinal thickness; also, combination therapy with bromfenac and corticosteroids may be associated with smaller changes in foveal thickness, macular thickness, and macular volume versus monotherapy with either treatment alone in this patient population. In two randomized, double-masked, placebo-controlled clinical trials with bromfenac 0.07%, CME was reported as an adverse event in 0.5% and 1.5% of patients receiving bromfenac and placebo, respectively. In an analysis of four placebo-controlled trials with bromfenac 0.09%, macular edema was reported in 0.7% and 1.4% of patients receiving bromfenac and placebo, respectively. When evaluated as treatment for acute or chronic CME, bromfenac was associated with improvement in visual acuity and reduction in retinal thickness, but few studies are available. Overall, published data suggest that bromfenac is safe and effective when used to prevent or treat CME. Large-scale placebo-controlled trials and greater standardization of CME measures are needed to establish optimal bromfenac regimens for the prophylaxis and treatment of CME following cataract surgery.
Collapse
Affiliation(s)
- John D Sheppard
- Virginia Eye Consultants; Department of Ophthalmology, Eastern Virginia Medical School, Norfolk, VA, US
| |
Collapse
|
11
|
Cardascia N, Palmisano C, Centoducati T, Alessio G. Topical nonsteroidal anti-inflammatory drugs as adjuvant therapy in the prevention of macular edema after cataract surgery. Int Ophthalmol 2016; 37:1127-1131. [PMID: 27766540 DOI: 10.1007/s10792-016-0374-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Accepted: 10/06/2016] [Indexed: 11/29/2022]
Abstract
PURPOSE The purpose of the study was to assess adjuvant treatment with topical nonsteroidal anti-inflammatory drugs (NSAIDs) (0.9 % bromfenac, 0.1 % nepafenac, 0.5 % indomethacin, or 0.1 % diclofenac) in addition to topical steroidal treatment with 0.1 % dexamethasone and 0.3 % netilmicin for prevention of cystoid macular edema (CME) after uneventful small incision cataract extraction with foldable intraocular lens (IOL) implantation. SETTING Institute of Ophthalmology, Department of Scienze Mediche di Base, Neuroscienze ed Organi di Senso, Aldo Moro University, Policlinico Consorziale di Bari, Bari, Italy. DESIGN A retrospective 6-month single center study. METHODS Patients were divided into groups according to treatment with topical drugs for 2 weeks, after phacoemulsification with foldable IOL implantation. CME incidence was evaluated by assessing retinal foveal thickness changes using spectral domain optical coherence tomography. All patients were treated with a fixed combination of dexamethasone and netilmicin, and some patients were additionally treated with NSAIDs (bromfenac, nepafenac, indomethacin, or diclofenac). RESULTS Fourteen patients were treated with bromfenac, 15 with nepafenac, 12 with indomethacin, and 14 with diclofenac; ten patients were treated with dexamethasone and netilmicin alone. At the end of the follow-up, macular thickness, evaluated at 1-week post-surgery, was reduced only in the group treated with nepafenac (-1.3 %, p = 0.048), was increased in the group treated with dexamethasone and netilmicin alone (+4.3 %, p = 0.04), and did not change in the groups treated with bromfenac (-1.1 %, p = 0.3), indomethacin (+0.1 %, p = 0.19), or diclofenac (+1.2 %, p = 0.74). There were no side effects in any group. CONCLUSIONS Topical treatment with nepafenac, bromfenac, and indomethacin enhanced the efficacy of steroids to reduce postoperative macular edema. Diclofenac did not improve steroids efficacy.
Collapse
Affiliation(s)
- Nicola Cardascia
- Dipartimento di Scienze Mediche di Base, Neuroscienze ed Organi di Senso. Sezione di Oftalmologia, Università degli Studi di Bari Aldo Moro, Bari, Italy. .,RUO Oftalmologia, Policlinico Consorziale di Bari, p.zza G. Cesare, 11, 70124, Bari, Italy.
| | - Carmela Palmisano
- Dipartimento di Scienze Mediche di Base, Neuroscienze ed Organi di Senso. Sezione di Oftalmologia, Università degli Studi di Bari Aldo Moro, Bari, Italy
| | - Tersa Centoducati
- Dipartimento di Scienze Mediche di Base, Neuroscienze ed Organi di Senso. Sezione di Oftalmologia, Università degli Studi di Bari Aldo Moro, Bari, Italy
| | - Giovanni Alessio
- Dipartimento di Scienze Mediche di Base, Neuroscienze ed Organi di Senso. Sezione di Oftalmologia, Università degli Studi di Bari Aldo Moro, Bari, Italy
| |
Collapse
|
12
|
Bessette AP, Hariprasad SM, Singh RP. The Role of NSAIDs in the Management of Macular Edema. Ophthalmic Surg Lasers Imaging Retina 2016; 47:704-7. [PMID: 27548446 DOI: 10.3928/23258160-20160808-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
13
|
Bromfenac ophthalmic solution 0.09 %: human aqueous humor concentration detected by high-performance liquid chromatography. Int Ophthalmol 2016; 37:417-421. [PMID: 27324371 DOI: 10.1007/s10792-016-0279-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 06/10/2016] [Indexed: 12/14/2022]
Abstract
The purpose of this study was to evaluate the aqueous humor concentrations of bromfenac ophthalmic solution 0.09 % in patients undergoing phacoemulsification. Patients requiring cataract extraction received one drop (50 µL) of bromfenac 0.09 % solution in the eye to be operated, before bedtime the day before surgery or the morning of the surgery. The last administration was recorded. At the time of paracentesis, an aqueous humor sample was collected with a 30-gauge needle attached to a TB syringe and was later analyzed by high-performance liquid chromatography for drug concentration. 188 treated volunteers and 48 control, untreated, subjects were included in the study. The mean aqueous concentration of bromfenac in the treated group was 37.60 ± 68.86 and 0 nM (nmol/L) in the control group (p < 0.0001). Correlation coefficient in bromfenac group between time elapsed from instillation and drug concentration was -0.16 (p not significant). Bromfenac showed properties of good penetration and stable concentration in aqueous humor up to about 12 h after instillation.
Collapse
|
14
|
Palacio C, Fernández De Ortega L, Bustos FR, Chávez E, Oregon-Miranda AA, Mercado-Sesma AR. Bromfenac 0.09% bioavailability in aqueous humor, prophylactic effect on cystoid macular edema, and clinical signs of ocular inflammation after phacoemulsification in a Mexican population. Clin Ophthalmol 2016; 10:233-7. [PMID: 26869758 PMCID: PMC4734805 DOI: 10.2147/opth.s93530] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The purpose of this study was to evaluate the aqueous humor bioavailability and clinical efficacy of bromfenac 0.09% vs nepafenac on the presence of cystoid macular edema (CME) after phacoemulsification. MATERIAL AND METHODS A Phase II, double-blind, masked, active-controlled, multicenter, clinical trial of 139 subjects, randomized to either a bromfenac 0.09% ophthalmic solution (n=69) or nepafenac 0.1% (n=70). Subjects instilled a drop three times a day for a period of 30 days. Follow-up visits were on days 2, 7, 15, 30, and 60. Biomicroscopy, clinical ocular signs, and assessment of posterior segment were performed. The primary efficacy endpoints included the presence of CME evaluated by optical coherence tomography. Safety evaluation included intraocular pressure, transaminase enzymes, lissamine green, and fluorescein stain. RESULTS The demographic and efficacy variables were similar between groups at baseline. The presence of pain, photophobia, conjunctival hyperemia, chemosis, cellularity, and corneal edema disappeared by day 30 in both groups. The central retinal thickness did not show significant changes after treatment when compared to baseline as follows: in the bromfenac group (247.2±32.9 vs 252.0±24.9 μm; P=0.958) and in nepafenac group (250.8±34 vs 264.0±34.1 μm; P=0.137), respectively. A statistically significant difference was observed between bromfenac and nepafenac group: (252.0±24.9 vs 264.0±34.1 μm; P=0.022), at day 30, respectively; even though there was no clinical relevance in the presentation of CME. There were no significant alterations in intraocular pressure, either lissamine green or fluorescein stains. The adverse events were not related to the interventions. CONCLUSION Bromfenac 0.09% ophthalmic solution showed similar clinical efficacy to reduce the presentation of CME after phacoemulsification compared to nepafenac 0.01%.
Collapse
Affiliation(s)
- Claudia Palacio
- Anterior Segment Department, Fundación Hospital Nuestra Señora de la Luz, México City, México
| | - Lourdes Fernández De Ortega
- Anterior Segment Department, Asociación Para Evitar la Ceguera en México, Hospital Dr Luis Sánchez Bulnes, México
| | - Francisco R Bustos
- Anterior Segment Department, Antiguo Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Jalisco, México
| | - Eduardo Chávez
- Anterior Segment Department, Instituto de Oftalmología, Fundación de Asistencia Privada Conde de Valenciana, IAP, México
| | - Aldo A Oregon-Miranda
- Clinical Research Department, Laboratorios Sophia, SA de CV, Zapopan, Jalisco, México
| | - Arieh R Mercado-Sesma
- Clinical Research Department, Laboratorios Sophia, SA de CV, Zapopan, Jalisco, México
| |
Collapse
|
15
|
Semeraro F, Russo A, Gambicorti E, Duse S, Morescalchi F, Vezzoli S, Costagliola C. Efficacy and vitreous levels of topical NSAIDs. Expert Opin Drug Deliv 2015; 12:1767-82. [PMID: 26173446 DOI: 10.1517/17425247.2015.1068756] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Nonsteroidal anti-inflammatory drugs (NSAIDs) are one of the most commonly prescribed medications and are routinely used for their analgesic, antipyretic, and anti-inflammatory properties. Because of their potent cyclooxygenase-inhibitory activity, they can inhibit pro-inflammatory prostaglandin synthesis, leading to complex inflammatory cascades. NSAIDs have been broadly used systemically for many decades and have recently become commercially available in the form of topical ophthalmic formulations. NSAIDs are weak acids with pKa values mostly between 3.5 and 4.5 and are poorly water-soluble. New, aqueous ophthalmic solutions of NSAIDs that afford better tissue penetration have recently been developed. In ophthalmological practice, topical NSAIDs are mostly used to stabilize pupillary dilation during intraocular surgery, manage postoperative pain and inflammation, and treat pseudophakic cystoid macular edema. AREAS COVERED This review focuses on the vitreous penetration of topical NSAIDs and their potential clinical applications in the treatment of retinal diseases. EXPERT OPINION A growing body of evidence suggests that NSAIDs may be beneficial in the treatment of age-related macular degeneration, diabetic retinopathy, and ocular tumors. Recent studies from our group and other authors have shown that the vitreous levels of NSAID exceed the median inhibitory concentration, which can significantly decrease vitreous PGE2 levels.
Collapse
Affiliation(s)
- Francesco Semeraro
- a 1 University of Brescia, Department of Medical and Surgical Specialties, Radiological Specialties and Public Health, Ophthalmology Clinic , Brescia, Italy +390303995308 ; +390303388191 ;
| | - Andrea Russo
- a 1 University of Brescia, Department of Medical and Surgical Specialties, Radiological Specialties and Public Health, Ophthalmology Clinic , Brescia, Italy +390303995308 ; +390303388191 ;
| | - Elena Gambicorti
- a 1 University of Brescia, Department of Medical and Surgical Specialties, Radiological Specialties and Public Health, Ophthalmology Clinic , Brescia, Italy +390303995308 ; +390303388191 ;
| | - Sarah Duse
- a 1 University of Brescia, Department of Medical and Surgical Specialties, Radiological Specialties and Public Health, Ophthalmology Clinic , Brescia, Italy +390303995308 ; +390303388191 ;
| | - Francesco Morescalchi
- a 1 University of Brescia, Department of Medical and Surgical Specialties, Radiological Specialties and Public Health, Ophthalmology Clinic , Brescia, Italy +390303995308 ; +390303388191 ;
| | - Sara Vezzoli
- b 2 University of Brescia, Department of Medical and Surgical Specialties, Radiological Specialties and Public Health, Forensic Medicine , Brescia, Italy
| | - Ciro Costagliola
- c 3 University of Molise, Department of Medicine and Health Sciences , Campobasso, Italy.,d 4 I.R.C.C.S Neuromed, Località Camerelle , Pozzilli (Isernia), Italy
| |
Collapse
|
16
|
Fujishima H, Fuseya M, Ogata M, Murat D. Efficacy of bromfenac sodium ophthalmic solution for treatment of dry eye disease. Asia Pac J Ophthalmol (Phila) 2015; 4:9-13. [PMID: 26068607 DOI: 10.1097/apo.0000000000000032] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To evaluate the efficacy of bromfenac sodium ophthalmic solution (BF) in patients with dry eye disease (DED) inadequately controlled by monotherapy with artificial tears (ATs). DESIGN An investigator-oriented trial with a single-arm, nonrandomized, open-label design. METHODS Twenty-six patients, who showed no symptomatic improvement of DED after 1 month of AT treatment, were enrolled. Bromfenac sodium ophthalmic solution was administered adjunctively with AT for 1 month. The BF treatment was then discontinued, and AT treatment alone was continued for 3 months. The signs and symptoms were evaluated at the beginning of BF treatment (Pre), at the end of the combined BF and AT treatment (BF1M), and at 1 and 3 months after discontinuation of BF treatment (Po1M and Po3M, respectively). RESULTS The dryness scores at BF1M were significantly improved compared with Pre (P < 0.001) and significantly superior to Po3M (P < 0.001). No significant changes in the Schirmer scores were observed throughout the treatment period. The tear film breakup time was significantly improved at BF1M (4.4 ± 2.3 seconds) compared with Pre (2.8 ± 1.8 seconds; P < 0.001). Superficial punctate keratopathy showed significant improvements in the total score of area and density at BF1M compared with Pre (P < 0.001). However, these parameters had significantly worsened at Po3M compared with BF1M. No adverse events were observed. CONCLUSIONS Bromfenac sodium ophthalmic solution has improved the dryness of the eye and signs of DED through its anti-inflammatory effects. Nonsteroidal anti-inflammatory drugs were suitable as anti-inflammatory ophthalmic solutions for patients with DED.
Collapse
Affiliation(s)
- Hiroshi Fujishima
- From the *Department of Ophthalmology, Tsurumi University School of Dental Medicine, Kanagawa; and †Department of Ophthalmology, Tokyo Saiseikai Central Hospital; and ‡J&J Ocular Surface and Visual Optics Department, Keio University School of Medicine, Tokyo, Japan
| | | | | | | |
Collapse
|
17
|
Baklayan GA, Muñoz M. The ocular distribution of (14)C-labeled bromfenac ophthalmic solution 0.07% in a rabbit model. Clin Ophthalmol 2014; 8:1717-24. [PMID: 25228788 PMCID: PMC4160328 DOI: 10.2147/opth.s66638] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
PURPOSE To evaluate the ocular distribution of an advanced formulation of bromfenac ophthalmic solution. Two studies were conducted in rabbits: 1) a 12-hour parallel-group study comparing the ocular distribution of (14)C-bromfenac ophthalmic solution 0.07%, pH 7.8 with that of (14)C-bromfenac ophthalmic solution 0.09%, pH 8.3, and 2) a 24-hour study evaluating the ocular distribution of (14)C-bromfenac ophthalmic solution 0.07%, pH 7.8. METHODS In the 12-hour study, rabbits were randomized to receive 50 μL of (14)C-bromfenac 0.07%, pH 7.8 or 50 μL (14)C-bromfenac 0.09%, pH 8.3 in one eye, whereas, in the 24-hour, study both eyes received 50 μL of (14)C-bromfenac 0.07%, pH 7.8. Ocular tissues were collected at 1, 2, 4, 8, 12 (both studies) and 24 hours (second study only) following drug instillation, and tissue radioactivity was determined using liquid scintillation chromatography. RESULTS Measureable levels of bromfenac were observed in all ocular tissues, with the exception of vitreous humor, regardless of formulation. In the 12-hour study, high concentrations of (14)C-bromfenac were found in the sclera, followed by the iris/ciliary body, aqueous humor, choroid, retina, and lens. There was no significant difference between the bromfenac 0.07%, pH 7.8 and bromfenac 0.09%, pH 8.3 formulations in any (14)C-bromfenac tissue levels at any time point, with the exception of in sclera at 2 hours post-instillation (0.451 μg eq/g versus 0.302 μg eq/g, respectively, P<0.001). There was also no significant difference in the total amount of (14)C-bromfenac in the tissues evaluated following instillation of the two formulations. In the 24-hour study evaluating bromfenac 0.07%, pH 7.8 only, high concentrations of (14)C-bromfenac were found 1 hour post-instillation in the cornea (2.402 μg eq/g) and conjunctiva (1.049 μg eq/g), two tissues not evaluated in the 12-hour study. The rank order of (14)C-bromfenac levels in the other ocular tissues was the same as that observed in the 12-hour study, with measureable amounts of (14)C-bromfenac detected through 24 hours in all tissues with the exception of vitreous humor. CONCLUSION Bromfenac ophthalmic solution 0.07%, pH 7.8 readily penetrated ocular tissues with levels similar to those of bromfenac ophthalmic solution 0.09%, pH 8.3.
Collapse
|
18
|
Shimura M, Yasuda K. Topical bromfenac reduces the frequency of intravitreal bevacizumab in patients with branch retinal vein occlusion. Br J Ophthalmol 2014; 99:215-9. [DOI: 10.1136/bjophthalmol-2013-304720] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
19
|
Guo S, Patel S, Baumrind B, Johnson K, Levinsohn D, Marcus E, Tannen B, Roy M, Bhagat N, Zarbin M. Management of pseudophakic cystoid macular edema. Surv Ophthalmol 2014; 60:123-37. [PMID: 25438734 DOI: 10.1016/j.survophthal.2014.08.005] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Revised: 08/24/2014] [Accepted: 08/26/2014] [Indexed: 01/08/2023]
Abstract
Pseudophakic cystoid macular edema (PCME) is a common complication following cataract surgery. Acute PCME may resolve spontaneously, but some patients will develop chronic macular edema that affects vision and is difficult to treat. This disease was described more than 50 years ago, and there are multiple options for clinical management. We discuss mechanisms, clinical efficacy, and adverse effects of these treatment modalities. Topical non-steroidal anti-inflammatory agents and corticosteroids are widely used and, when combined, may have a synergistic effect. Intravitreal corticosteroids and anti-vascular endothelial growth factor (anti-VEGF) agents have shown promise when topical medications either fail or have had limited effects. Randomized clinical studies evaluating anti-VEGF agents are needed to fully evaluate benefits and risks. When PCME is either refractory to medical therapy or is associated with significant vitreous involvement, pars plana vitrectomy has been shown to improve outcomes, though it is associated with additional risks.
Collapse
Affiliation(s)
- Suqin Guo
- Department of Ophthalmology, The Institute of Ophthalmology and Visual Science, New Jersey Medical School, Rutgers University, Newark, New Jersey, USA.
| | - Shriji Patel
- Department of Ophthalmology, The Institute of Ophthalmology and Visual Science, New Jersey Medical School, Rutgers University, Newark, New Jersey, USA
| | - Ben Baumrind
- Department of Ophthalmology, The Institute of Ophthalmology and Visual Science, New Jersey Medical School, Rutgers University, Newark, New Jersey, USA
| | - Keegan Johnson
- Department of Ophthalmology, The Institute of Ophthalmology and Visual Science, New Jersey Medical School, Rutgers University, Newark, New Jersey, USA
| | - Daniel Levinsohn
- Department of Ophthalmology, The Institute of Ophthalmology and Visual Science, New Jersey Medical School, Rutgers University, Newark, New Jersey, USA
| | - Edward Marcus
- Department of Ophthalmology, The Institute of Ophthalmology and Visual Science, New Jersey Medical School, Rutgers University, Newark, New Jersey, USA
| | - Brad Tannen
- Department of Ophthalmology, The Institute of Ophthalmology and Visual Science, New Jersey Medical School, Rutgers University, Newark, New Jersey, USA
| | - Monique Roy
- Department of Ophthalmology, The Institute of Ophthalmology and Visual Science, New Jersey Medical School, Rutgers University, Newark, New Jersey, USA
| | - Neelakshi Bhagat
- Department of Ophthalmology, The Institute of Ophthalmology and Visual Science, New Jersey Medical School, Rutgers University, Newark, New Jersey, USA
| | - Marco Zarbin
- Department of Ophthalmology, The Institute of Ophthalmology and Visual Science, New Jersey Medical School, Rutgers University, Newark, New Jersey, USA
| |
Collapse
|
20
|
Kida T, Kozai S, Takahashi H, Isaka M, Tokushige H, Sakamoto T. Pharmacokinetics and efficacy of topically applied nonsteroidal anti-inflammatory drugs in retinochoroidal tissues in rabbits. PLoS One 2014; 9:e96481. [PMID: 24796327 PMCID: PMC4010472 DOI: 10.1371/journal.pone.0096481] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Accepted: 04/09/2014] [Indexed: 11/26/2022] Open
Abstract
Purpose To evaluate the pharmacokinetics and efficacy of topically applied nonsteroidal anti-inflammatory drugs (NSAIDs) in the retinochoroidal tissues of rabbits. Methods The cyclooxygenase (COX) inhibitory activity of diclofenac, bromfenac, and amfenac, an active metabolite of nepafenac, were determined using human-derived COX-1 and COX-2. Each of the three NSAIDs was applied topically to rabbits, and after 0.5 to 8 hrs, the concentration of each drug in the aqueous humor and the retinochoroidal tissues was measured by liquid chromatography-tandem mass spectrometry. The pharmacokinetics of the drugs in the tissues after repeated doses as is done on patients was calculated by a simulation software. The inhibitory effect of each NSAID on the breakdown of the blood-retinal barrier was assessed by the vitreous protein concentration on concanavalin A-induced retinochoroidal inflammation in rabbits. Results The half-maximal inhibitory concentration (IC50) of diclofenac, bromfenac, and amfenac was 55.5, 5.56, and 15.3 nM for human COX-1, and 30.7, 7.45, and 20.4 nM for human COX-2, respectively. The three NSAIDs were detected in the aqueous humor and the retinochoroidal tissue at all-time points. Simulated pharmacokinetics showed that the levels of the three NSAIDs were continuously higher than the IC50 of COX-2, as an index of efficacy, in the aqueous humor, whereas only the bromfenac concentration was continuously higher than the IC50 at its trough level in the retinochoroidal tissues. The intravitreous concentration of proteins was significantly reduced in rabbits that received topical bromfenac (P = 0.026) but not the other two NSAIDs. Conclusions Topical bromfenac can penetrate into the retinochoroidal tissues in high enough concentrations to inhibit COX-2 and exerts its inhibitory effect on the blood-retinal barrier breakdown in an experimental retinochoroidal inflammation in rabbits. Topical bromfenac may have a better therapeutic benefit than diclofenac and nepafenac for retinochoroidal inflammatory diseases.
Collapse
Affiliation(s)
- Tetsuo Kida
- Research Laboratories for Drug Development, Senju Pharmaceutical Co., Ltd., Kobe, Japan
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Seiko Kozai
- Research Laboratories for Drug Development, Senju Pharmaceutical Co., Ltd., Kobe, Japan
| | - Hiroaki Takahashi
- Research Laboratories for Drug Development, Senju Pharmaceutical Co., Ltd., Kobe, Japan
| | - Mitsuyoshi Isaka
- Research Laboratories for Drug Development, Senju Pharmaceutical Co., Ltd., Kobe, Japan
| | - Hideki Tokushige
- Research Laboratories for Drug Development, Senju Pharmaceutical Co., Ltd., Kobe, Japan
| | - Taiji Sakamoto
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
- * E-mail:
| |
Collapse
|
21
|
Brookshire HL, English RV, Nadelstein B, Weigt AK, Gift BW, Gilger BC. Efficacy of COX-2 inhibitors in controlling inflammation and capsular opacification after phacoemulsification cataract removal. Vet Ophthalmol 2014; 18:175-85. [PMID: 24636042 DOI: 10.1111/vop.12159] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate the efficacy of 0.9% bromfenac (Xibrom™) or a celecoxib-impregnated intraocular lens (celecoxib-IOL) compared with 1% prednisolone acetate (PA) in controlling postoperative inflammation and posterior capsule opacification (PCO). ANIMAL STUDIED Fifty-nine dogs undergoing cataract extraction by phacoemulsification. PROCEDURE Bilateral patients received bromfenac or celecoxib-IOL plus PA in one eye, and PA in the contralateral eye. Unilateral patients received bromfenac or PA. Complete ophthalmic examination including tonometry, slit-lamp grading of flare and PCO, and digital image acquisition for masked PCO evaluation was performed within 24 h and 1, 4, 12, 24, and 56 weeks following surgery. RESULTS Celecoxib-IOL/PA-treated eyes had significantly less flare than PA-treated eyes, which had significantly less flare than bromfenac-treated eyes 24 h postoperatively. There was no significant difference in intraocular pressure (IOP) postoperatively, or at 1, 24, or 56 weeks. Celecoxib-IOL/PA-treated eyes had significantly lower IOP measurements than bromfenac and PA-treated eyes at 4 and 12 weeks. There was no significant difference in PCO level between groups using slit-lamp biomicroscopy at any time point. Masked evaluation of digital images revealed significantly less PCO in celecoxib-IOL/PA- vs. bromfenac-treated eyes at 4 weeks, and in bromfenac- vs. PA-treated eyes at 56 weeks. CONCLUSIONS Eyes receiving celecoxib-IOL/PA had better initial control of inflammation. Bromfenac was equally effective compared with PA in controlling inflammation. There was no association between COX-2 inhibitor administration and ocular hypertension. Celecoxib-IOL/PA-treated eyes showed better initial control of PCO (up to 12 weeks), while eyes receiving bromfenac had better long-term control of PCO (56 weeks).
Collapse
|
22
|
Rajpal RK, Ross B, Rajpal SD, Hoang K. Bromfenac ophthalmic solution for the treatment of postoperative ocular pain and inflammation: safety, efficacy, and patient adherence. Patient Prefer Adherence 2014; 8:925-31. [PMID: 25028541 PMCID: PMC4077855 DOI: 10.2147/ppa.s46667] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Ophthalmic nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used by clinicians to manage ocular inflammation and pain following cataract surgery. Over the past decade, the US Food and Drug Administration has approved multiple topical NSAIDs for these purposes, including several reformulated products. One of these medications, bromfenac ophthalmic solution, has a long and extensive history, with proven efficacy and safety in patients following cataract surgery. The evolution of bromfenac ophthalmic solution over the years has involved either lowering the concentration of the active ingredient or extending the dosing interval to improve patient adherence/compliance. This review will focus on the history and progression of bromfenac ophthalmic solution and report the available patient preference and adherence data regarding this ocular NSAID throughout its evolution.
Collapse
Affiliation(s)
- Rajesh K Rajpal
- See Clearly Vision Group, McLean, VA, USA
- Correspondence: Rajesh Rajpal, See Clearly Vision Group, 8138 Watson St, McLean, VA 22102, USA, Email
| | - Bryan Ross
- See Clearly Vision Group, McLean, VA, USA
| | | | - Khoa Hoang
- See Clearly Vision Group, McLean, VA, USA
| |
Collapse
|
23
|
Walters TR, Goldberg DF, Peace JH, Gow JA. Bromfenac Ophthalmic Solution 0.07% Dosed Once Daily for Cataract Surgery. Ophthalmology 2014; 121:25-33. [DOI: 10.1016/j.ophtha.2013.07.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2013] [Revised: 07/02/2013] [Accepted: 07/09/2013] [Indexed: 12/20/2022] Open
|
24
|
Inflammation and macular oedema after pars plana vitrectomy. Mediators Inflamm 2013; 2013:971758. [PMID: 24288446 PMCID: PMC3833009 DOI: 10.1155/2013/971758] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Accepted: 09/23/2013] [Indexed: 11/29/2022] Open
Abstract
Cystoid macular oedema (CMO) is a major cause of reduced vision following intraocular surgery. Although the aetiology of CMO is not completely clarified, intraocular inflammation is known to play a major role in its development. The macula may develop cytotoxic oedema when the primary lesion and fluid accumulation occur in the parenchymatous cells (intracellular oedema) or vasogenic oedema when the primary defect occurs in the blood-retinal barrier and leads to extracellular fluid accumulation (extracellular oedema). We report on the mechanisms of CMO formation after pars plana vitrectomy and associated surgical procedures and discuss possible therapeutic approaches.
Collapse
|
25
|
TOPICAL BROMFENAC AS AN ADJUNCTIVE TREATMENT WITH INTRAVITREAL RANIBIZUMAB FOR EXUDATIVE AGE-RELATED MACULAR DEGENERATION. Retina 2012; 32:1804-10. [DOI: 10.1097/iae.0b013e31825be87f] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
26
|
Carreño E, Portero A, Galarreta DJ, Herreras JM. Update on twice-daily bromfenac sodium sesquihydrate to treat postoperative ocular inflammation following cataract extraction. Clin Ophthalmol 2012; 6:637-44. [PMID: 22570544 PMCID: PMC3346189 DOI: 10.2147/opth.s23381] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Ophthalmic bromfenac sodium sesquihydrate is a topically applied selective cyclooxygenase (COX)-2 inhibitor. It is similar to amfenac, except for a bromine atom at the C(4) of the benzoyl ring position, which markedly affects its in vitro and in vivo potency, extends the duration of anti-inflammatory activity, and enhances its inhibitory effect on COX-2 absorption across the cornea and penetration into ocular tissues. The United States Food and Drug Administration approved bromfenac in 2005 for the treatment of postoperative inflammation and the reduction of ocular pain in patients who have undergone cataract surgery. Nonsteroidal anti-inflammatory drugs (NSAIDs), and among them bromfenac, could be even more effective than steroids at reestablishing the blood-aqueous barrier, as revealed by flare on slit-lamp examination and as quantitatively measured using ocular fluorophotometry. Similar to other NSAIDs, it has a role in inhibiting intraoperative miosis during cataract surgery. However, bromfenac also seems to be useful in other situations, such as refractive surgery, allergic conjunctivitis (not useful in dry eye), choroidal neovascularization, and even ocular oncology. No reports of systemic toxicity have been published and bromfenac has good topical tolerance with a low incidence of adverse effects.
Collapse
Affiliation(s)
- Ester Carreño
- Ocular Immunology Unit-IOBA (Instituto Universitario de Oftalmobiología), University of Valladolid, Campus Miguel Delibes, Valladolid, Spain
| | | | | | | |
Collapse
|
27
|
Abstract
PURPOSE OF REVIEW Pseudophakic cystoid macular edema (PCME) is a common cause of visual impairment after cataract surgery. This article systematically reviews and discusses the epidemiology, risk factors, diagnosis, and treatment of PCME, with a focus on advances in the past 1-2 years. RECENT FINDINGS The incidence of PCME has declined with the advent of modern surgical techniques. Optical coherence tomography (OCT) has become an important adjunct to biomicroscopy and fluorescein angiography. PCME prophylaxis with topical nonsteroidal anti-inflammatory drugs remains unproven because long-term visual outcomes and comparative effectiveness studies are lacking. Chronic, refractory CME remains a therapeutic challenge, but investigational therapies with potential include corticosteroid intravitreal injections and implants, and intravitreal anti-vascular endothelial growth factor treatments. Few studies have assessed surgical options. SUMMARY There is currently a lack of well designed randomized clinical trials to guide the treatment of PCME.
Collapse
|
28
|
Toris CB, Gulati V. The biology, pathology and therapeutic use of prostaglandins in the eye. ACTA ACUST UNITED AC 2011. [DOI: 10.2217/clp.11.42] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
29
|
Silverstein SM, Cable MG, Sadri E, Peace JH, Fong R, Chandler SP, Gow JA, Klier SM, McNamara TR. Once daily dosing of bromfenac ophthalmic solution 0.09% for postoperative ocular inflammation and pain. Curr Med Res Opin 2011; 27:1693-703. [PMID: 21751945 DOI: 10.1185/03007995.2011.597663] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To evaluate the efficacy and ocular safety of bromfenac ophthalmic solution 0.09% dosed once daily for the treatment of ocular inflammation and pain following cataract extraction with posterior chamber intraocular lens implantation. METHODS A total of 455 subjects (455 study eyes: 230 bromfenac, 225 placebo) were enrolled in two randomized double-masked, placebo-controlled, clinical trials at 64 ophthalmology clinics in the United States. Subjects were randomized to receive either bromfenac 0.09% or placebo dosed once daily. Dosing began 1 day before cataract surgery (Day -1), continued on day of surgery (Day 0), and for 14 days following surgery. Evaluations were completed on Days 1, 3, 8, 15 and 22. The primary efficacy endpoint was cleared summed ocular inflammation score (SOIS) by Day 15. The secondary efficacy endpoint was the number of subjects who were pain-free at Day 1. RESULTS The bromfenac 0.09% group was significantly higher compared to the placebo group in the primary endpoint of the proportion of subjects who had cleared ocular inflammation by Day 15 (P < 0.0001). The mean SOIS for the bromfenac 0.09% group was lower than the placebo group at Days 3, 8, 15, and 22 (P < 0.0001). More bromfenac 0.09% subjects were pain free at Days 1, 3, 8, and 15 (P < 0.0001). Fewer subjects in the bromfenac 0.09% group withdrew from the clinical trials due to lack of efficacy at Day 15 (P < 0.0001). Fewer adverse events were reported in the bromfenac 0.09% group than the placebo group. Limitations included advanced age, female predominance, and surgical nuances among cataract surgeons, making cross-trial comparisons difficult. CONCLUSIONS Bromfenac ophthalmic solution 0.09% dosed once daily is clinically safe and effective for the treatment of ocular inflammation and the reduction of ocular pain associated with cataract surgery.
Collapse
|
30
|
Henderson BA, Gayton JL, Chandler SP, Gow JA, Klier SM, McNamara TR. Safety and efficacy of bromfenac ophthalmic solution (Bromday) dosed once daily for postoperative ocular inflammation and pain. Ophthalmology 2011; 118:2120-7. [PMID: 21762992 DOI: 10.1016/j.ophtha.2011.04.035] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2010] [Revised: 04/22/2011] [Accepted: 04/27/2011] [Indexed: 11/15/2022] Open
Abstract
PURPOSE To evaluate the efficacy and ocular safety of bromfenac ophthalmic solution (bromfenac) 0.09% dosed once daily for the treatment of ocular inflammation and pain after cataract surgery with posterior chamber intraocular lens implantation. DESIGN Randomized, double-masked, vehicle-controlled or active-controlled, multicenter, clinical trials. PARTICIPANTS AND CONTROLS A total of 872 subjects (872 study eyes: bromfenac in 584, placebo in 288). METHODS Four randomized, double-masked, vehicle or active-controlled, clinical trials were conducted at 134 ophthalmology clinics in the United States. Subjects aged ≥ 18 years were randomized to receive either bromfenac 0.09% or placebo dosed once daily beginning 1 day before cataract surgery (day -1), continuing on the day of surgery (day 0), and continuing for an additional postoperative 14 days. Subjects were evaluated for efficacy and safety on days 1, 3, 8, 15, and 22. The primary efficacy end point was cleared ocular inflammation, measured by the summed ocular inflammation score (SOIS; anterior chamber cells and flare) by day 15. The secondary efficacy end point was the number of subjects who were pain-free at day 1. The data from the 4 trials were pooled for analyses. MAIN OUTCOME MEASURES The SOIS and ocular pain. RESULTS The proportion of subjects who had cleared ocular inflammation by day 15 was significantly higher in the bromfenac 0.09% group than in the placebo group (P < 0.0001). The mean SOIS in the bromfenac 0.09% group was significantly lower than in the placebo group at days 3, 8, 15, and 22 (P < 0.0001). The proportion of subjects who were pain-free at days 1, 3, 8, and 15 was significantly higher in the bromfenac 0.09% group than in the placebo group (P < 0.0001). The incidence of adverse events reported in the bromfenac 0.09% group was significantly lower than in the placebo group (P < 0.0001). On day 15, 84.0% of the bromfenac subjects had ≥ 1-line improvement in visual acuity compared with 66.1% of placebo subjects (P < 0.0001). CONCLUSIONS Bromfenac 0.09% dosed once daily was clinically safe and effective for reducing and treating ocular inflammation and pain associated with cataract surgery. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found after the references.
Collapse
|
31
|
Reddy R, Kim SJ. Critical appraisal of ophthalmic ketorolac in treatment of pain and inflammation following cataract surgery. Clin Ophthalmol 2011; 5:751-8. [PMID: 21750608 PMCID: PMC3130912 DOI: 10.2147/opth.s7633] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2011] [Indexed: 11/23/2022] Open
Abstract
Background: The purpose of this review was to provide a critical appraisal of the literature supporting the efficacy of ophthalmic ketorolac (Acuvail®) in the treatment of pain and inflammation after cataract surgery. Methods: Literature search and expert opinion of the authors. Results: Recent studies indicate greater intraocular drug levels in the anterior chamber and iris-ciliary body after topical application of Acuvail in comparison with older formulations of ketorolac. A large randomized, multicenter, placebo-controlled study demonstrated significantly less inflammation and pain after cataract surgery using Acuvail. Conclusion: Acuvail appears to be effective in reducing post-cataract surgery pain and inflammation.
Collapse
Affiliation(s)
- Rahul Reddy
- Department of Ophthalmology, Vanderbilt University, Nashville, TN, USA
| | | |
Collapse
|
32
|
Si EC, Bowman LM, Hosseini K. Pharmacokinetic Comparisons of Bromfenac in DuraSite and Xibrom. J Ocul Pharmacol Ther 2011; 27:61-6. [DOI: 10.1089/jop.2010.0103] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Erwin C. Si
- Department of Preclinical Research, InSite Vision, Alameda, California
| | - Lyle M. Bowman
- Department of Development, InSite Vision, Alameda, California
| | - Kamran Hosseini
- Department of Preclinical Research, InSite Vision, Alameda, California
- Clinical Operations and Medical Affairs, InSite Vision, Alameda, California
| |
Collapse
|
33
|
|
34
|
Kim SJ, Flach AJ, Jampol LM. Nonsteroidal anti-inflammatory drugs in ophthalmology. Surv Ophthalmol 2010; 55:108-33. [PMID: 20159228 DOI: 10.1016/j.survophthal.2009.07.005] [Citation(s) in RCA: 245] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2009] [Revised: 07/20/2009] [Accepted: 07/28/2009] [Indexed: 02/02/2023]
Abstract
Nonsteroidal anti-inflammatory drugs (NSAIDs) are increasingly employed in ophthalmology to reduce miosis and inflammation, manage scleritis, and prevent and treat cystoid macular edema associated with cataract surgery. In addition, they may decrease postoperative pain and photophobia associated with refractive surgery and may reduce the itching associated with allergic conjunctivitis. In recent years, the U.S. Food and Drug Administration has approved new topical NSAIDs, and previously approved NSAIDs have been reformulated. These additions and changes result in different pharmacokinetics and dosing intervals, which may offer therapeutic advantages. For example, therapeutic effects on diabetic retinopathy and age-related macular degeneration may now be achievable. We provide an updated review on NSAIDs and a summary of their current uses in ophthalmology with attention to potential future applications.
Collapse
Affiliation(s)
- Stephen J Kim
- Department of Ophthalmology, Vanderbilt University, Nashville, Tennessee 37232, USA.
| | | | | |
Collapse
|
35
|
RETROSPECTIVE REVIEW OF THE EFFICACY OF TOPICAL BROMFENAC (0.09%) AS AN ADJUNCTIVE THERAPY FOR PATIENTS WITH NEOVASCULAR AGE-RELATED MACULAR DEGENERATION. Retina 2009; 29:1527-31. [DOI: 10.1097/iae.0b013e3181b32f4c] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|