Clinical experience with epinastine in patients with seasonal allergic conjunctivitis in ophthalmological practice

BACKGROUND: Allergic conjunctivitis involves an inflammatory reaction that destabilizes the tear film and promotes dry eye syndrome. Topical antihistamines may contribute to ocular surface dryness.

Aim: The study aimed to compare the tolerability and clinical effect of topical dual-action anti-allergic agents, including 0.05% epinastine, 0.2% olopatadine, and 0.1% olopatadine, in patients with seasonal allergic conjunctivitis in a standard clinical practice.

METHODS: The study included 33 patients (66 eyes) with seasonal allergic conjunctivitis. The patients were equally divided into three groups to receive 0.05% epinastine (n=11), 0.2% olopatadine (n=11), and 0.1% olopatadine (n=11). Symptom severity was assessed using the itching scale, Efron grading scale, eyelid edema scale, and Munk scale for epiphora grading. Dry eye symptoms were assessed using the Schirmer and Norn tests. The therapy duration was 14±2 days.

RESULTS: By the study end, mean tear film breakup time in the 0.05% epinastine group almost did not change compared to baseline and was 9.4±1.41 s vs. 9.6±1.39 s (OD) and 9.3±1.34 s vs. 9.5±1.43 s (OS). However, in the 0.1% and 0.2% olopatadine groups, it decreased and was 13.9±3.21 s vs. 11.6±2.88 s (OD) (p=0.043), 14.1±3.25 s vs. 11.6±3.06 s (OS) (p=0.019) and 10.63±1.51 s vs. 8.5±1.41 s (OD) (p=0.003), 10.75±1.28 s vs. 8.63±1.3 s (OS) (p=0.003), respectively. The lowest number of adverse reactions was observed in the 0.05% epinastine group.

CONCLUSIONS: 0.05% epinastine caused less dry eye symptoms and was well tolerated in patients with seasonal allergic conjunctivitis.