The ability of a drug to penetrate into the ocular tissues is key to controlling inflammation.
“All fluorometholones are not the same,” said Beeran Meghpara, MD, and with good reason. Fluorometholone is the active steroid in formulations used to treat ocular inflammation— however, it is what doesn’t meet the eye that makes the difference, i.e., the vehicle.
If the vehicle prevents the drug from optimally penetrating through the ocular surface into the underlying tissue, the drug will not be as effective as if the penetration was at its potential peak, said Dr. Meghpara, co-director of Refractive Surgery, Wills Eye Hospital, and clinical assistant professor of ophthalmology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia.
What makes the difference for Dr. Meghpara in his practice is the acetate component of fluorometholone acetate ophthalmic suspension (Flarex, Eyevance Pharmaceuticals).
“The acetate in the formulation makes the drug more lipophilic, which facilitates better penetration into the ocular surface,” he explained, resulting in a more potent treatment effect compared with a regular fluorometholone, i.e., without acetate, with the same side effect profile.
The side effects of steroids used to treat ocular diseases have historically been the greatest concerns. These include elevated IOP leading to glaucoma, a higher incidence of cataract formation, worsening of concurrent infections, and delayed healing.
“Generally speaking, the higher the potency of the steroid, the more likely it is that side effects will develop and that they will be worse,” Dr. Meghpara explained.
Fluorometholone acetate, however, is considered one of the safer steroids. When side effects do occur, it is with a lower frequency and they are less severe, he noted.
Beeran Meghpara, MD
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Dr. Meghpara is a speaker for Eyevance Pharmaceuticals.