OCULAR ALLERGY INSIGHTS … SPONSORED BY ISTA PHARMACEUTICALS

Treating Severe Itch Associated With Allergic Conjunctivitis

Fast-acting and comfortable, BEPREVE^® calms severe ocular itching in trials and in practice.

By Anish U. Shah, MD,
Norwich Ophthalmology Group, Connecticut

Norwich, Connecticut, where my practice is located, is suburban with charming farms dotting the countryside and a huge variety of trees that put on a spectacular show throughout the year. Unfortunately, residents with allergies pay a price for this natural beauty from early spring through late fall, when we are bombarded with pollen. As a result, my comprehensive ophthalmology practice has a large population of patients with allergic conjunctivitis, many of them complaining of severe ocular itch. Given the regularity with which I see these patients, I have developed an effective and efficient way of caring for them.

Simplifying treatment of severe symptoms

A thorough history along with a slit lamp examination, including lid eversion, usually clinches a diagnosis of ocular allergy. In fact, when I see patients have asthma, contact dermatitis or seasonal allergies or that they take over-the-counter or prescription allergy medications on the intake form, that is often a great diagnostic clue — even before my examination — that they may have allergic conjunctivitis. My examination usually confirms the diagnosis.

BEPREVE^® (bepotastine besilate ophthalmic solution) 1.5% (ISTA Pharmaceuticals, Inc.) is my first-line treatment for most of my patients with ocular itching associated with allergic conjunctivitis, including those with severe symptoms. I have found patients with the worst symptoms — severe itching with the need to rub their eyes — frequently have concomitant conditions that need to be evaluated and treated. For example, for therapy to be successful, it is important to diagnose, through careful history and examination, other underlying problems, such as blepharitis or dry eye. I then can tailor pharmacologic therapy and add lid scrubs or artificial tears as needed. As I address these other issues, I can rapidly relieve the severe ocular itch associated with allergic conjunctivitis by prescribing BEPREVE to keep patients comfortable throughout the allergy season.

What patients want

I weigh the evidence from well-controlled clinical trials against my own experience in clinical practice with regards to a medication's efficacy, safety, durability and tolerability. The responses I see in patients using BEPREVE closely mirror those reported in clinical studies. For example, investigators using the conjunctival allergen challenge model found BEPREVE eliminated ocular itch in 68% of eyes with severe symptoms when measured as early as 3 minutes post challenge, compared to only 3% of eyes treated with placebo.¹ Almost as important to patients as fast relief is comfort, and BEPREVE has demonstrated statistically equivalent comfort to placebo in a safety study.² Overall, BEPREVE was well tolerated in clinical trials. The most common adverse reaction occurring in approximately 25% of patients was a mild taste following instillation. Other adverse reactions occurring in 2% to 5% of patients were eye irritation, headache and nasopharyngitis.³

Another reason why my patients and I like BEPREVE is because one 10 mL bottle provides a 2-month supply. For about half of my patients with allergic conjunctivitis, one bottle will be sufficient for the duration of the allergy season. Even patients with perennial allergies — pet dander can be a problem, and mold is prevalent here in the Connecticut River Valley — only have to refill their prescriptions six times throughout the year. Given our busy lifestyles, I think we all appreciate fewer trips to the pharmacy.

Once they've taken the trouble to schedule an office visit, these are the characteristics of a treatment for itching associated with allergic conjunctivitis that my patients expect from me: rapid and durable relief from a comfortable drop that represents a good value.

Go-to drop for ocular allergy

Whether patients have mild, moderate or severe itch associated with allergic conjunctivitis, BEPREVE is usually part of my treatment plan. It is an effective product that is well-tolerated and cost-effective.

References

1. Clark JC, Williams JI, Gow JA, Abelson MB, McNamara TR; Bepotastine Besilate Ophthalmic Solutions Clinical Study Group. Bepotastine besilate ophthalmic solution 1.5% rapidly eliminates ocular itching in more severely allergic subjects in the conjunctival allergen challenge model of allergic conjunctivitis. Poster presented at: Eastern Allergy Conference; May 6-9, 2010; Palm Beach, FL.
2. Williams JI, Ackerman SL, Dao JT, Reddy TA, McNamara TR, Gow JA. The ocular comfort of bepotastine besilate ophthalmic solution 1.5% in a safety clinical trial. Poster presented at: 88th Annual Meeting of the American Society of Optometry; November 17-20, 2010; San Francisco, CA.
3. BEPREVE. ISTA Pharmaceuticals^®, Inc. Package insert.
4. Cigarette smoke. National Institute of Environmental Health Sciences – National Institutes of Health. http://www.niehs.nih.gov/health/topics/conditions/asthma/allergens/smoke/index.cfm. Accessed June 22, 2011.