Loteprednol etabonate in the treatment of allergic conjunctivitis: a meta-analysis.

OBJECTIVE:

This meta-analysis was designed to assess the efficacy, as well as the safety of loteprednol etabonate (LE) ophthalmic suspension compared with placebo and other commonly used eye drops for treatment of allergic conjunctivitis.

METHODS:

Comprehensive searches of randomized controlled trials were carried out in database of Medline, Embase and the Cochrane Library. Eight qualified studies were included. We assessed the reduction from baseline in scores of cardinal signs and symptoms, proportion of patients with improvement of allergic signs and symptoms and incidence of clinically significant intraocular pressure (IOP) elevation (IOP elevation ≥ 10 mmHg).

RESULTS:

The results showed that topical LE was significantly superior to placebo in reduction from baseline in signs scores (standardized mean differ ence [SMD], -0.48; 95% confidence interval [CI], -0.65 to -0.32) and symptoms scores (weighted mean difference (WMD), -0.51; 95% CI, -0.64 to -0.38) of allergic conjunctivitis, and as effective as olopatadine and fluorometholone acetate. Topical LE was associated with higher improvement rate of signs (risk ratio [RR], 1.53; 95% CI, 1.26 to 1.86; I(2) =57%) and symptoms (RR, 1.29; 95% CI, 1.15 to 1.46; I(2) =54%) than placebo and positive control treatment. Clinically significant IOP elevation was more frequent in group of LE than group of control treatment (pooled OR, 3.03; 95% CI, 1.04 to 8.80), which was affected by the response to corticosteroid of the individual patient, the wearing of contact lenses.

CONCLUSIONS:

Topical LE is effective in treating allergic conjunctivitis. However, it should be used with caution due to higher incidence of IOP elevation compared with placebo and olopatadine. A large-scale trial would be required to confirm the effect of different concentrations of LE on IOP.