Research Digest

Blepharitis Treatment Shows Promise

Two recent studies indicate that topical azithromycin 1% ophthalmic solution (AzaSite, Inspire Pharmaceuticals) has potential as a safe, well-tolerated and effective treatment for posterior and anterior blepharitis.

The first study,¹ published in Advances in Therapeutics, examined 21 patients diagnosed with posterior blepharitis in a randomized, open-label study. Ten patients received azithromycin and warm compresses; 11 received compresses alone. Both groups were assigned to apply compresses to each eye for 5 to 10 minutes b.i.d. for 14 days. Eyes in the azithromycin group also received the drug (1 drop) b.i.d. for the first 2 days, followed by q.d. for the next 12 days.

Investigators evaluted patients at study initiation and at end of treatment for severity of these clinical signs: eyelid debris, eyelid redness, eyelid swelling, meibomian gland (MG) plugging and the quality of MG secretion.

At the end of treatment, patients in the azithromycin group demonstrated "significant improvements" in MG plugging, MG secretions and eyelid redness as compared with the compress-only group.

In the second study, presented at the 2008 European Society of Cataract and Refractive Surgeons meeting,² researchers evaluated azithromcyin 1% for use in the treatment of chronic, mixed (staphylococcal and seborrheic) anterior blepharitis using an off-label administration technique that involved direct application to the eyelids. One hundred fifty eyes (75 patients) diagnosed with chronic mixed anterior blepharitis were treated for either 4 or 8 weeks in the prospective, randomized, open-label study.

Both eyes of each patient were treated with azithromycin 1% solution or erythromycin ophthaltmic ointment. Blepharitis was graded according to presence of collarettes, ulcerations at the base of eyelashes, matting of eyelashes and lid margin erythema.

Patients were instructed to apply azithromycin to their cleansed index finger or to a clean applicator and then to apply the medication directly to the eyelids. At 4 weeks, total clnical resolution was 98.5% for the azithromycin-treated group and 37.5% for the erythromycin-treated group. At 8 weeks, total clinical resolution was 98.5% for the azithromycin group and 50% for the erythromycin group. OM

References

1. Luchs J. Efficacy of topical azithromycin ophthalmic solution 1% in the treatment of posterior blepharitis. Adv Ther. Sept. 9, 2008. E-pub ahead of print.
2. John T, Shah AA. Use of azithromycin ophthalmic solution in the treatment of chronic mixed anterior blepharitis. Paper presented at: XXVI Congress of the European Society of Cataract and Refractive Surgery; 13-17 September 2008; Berlin, Germany.