Patients with ocular allergies seek comfort, relief

Olopatadine 0.1% (Patanol, Alcon Laboratories) was the drug of choice in an efficacy and comfort comparison with ketotifen 0.025% (Zaditor, Novartis Ophthalmics).

A greater percentage of patients reported that olopatadine was more efficacious and comfortable in the treatment of ocular allergy symptoms, according to study authors Andrea Leonardi, MD, and Panayotis Zafirakis, MD.

The multicenter, double-masked environmental patient-preference trial was conducted in Italy and Greece, where the investigators reported that the incidence of rhinoconjunctivitis has been reported to be present in 10% to 22% of the general population.

"The gathering of patient perception data will be important in determining therapy options with which patients are more satisfied, therefore increasing the ability of the practitioner to select the primary therapy with greater chances of yielding successful treatment. Novel mechanisms of action can be important advancements; however, the actual success of a therapy can hinge on the selection or recommendation by the medical practitioner. The compliance and satisfaction of patients can be valuable information to the practitioner in making his important decision," the authors stated. Dr. Leonardi, assistant professor, Department of Neuroscience, Ophthalmology Unit, University of Padua, Padua, Italy, and Dr. Zafirakis, affiliated with Diagnostic and Therapeutic Eye Center, Athens, Greece, reported their findings in Current Medical Research and Opinions (2004;20:1167-1173).

The study was conducted in the late summer and fall of 2003 when the airborne allergens included ragweed, bluegrass, goosefoot, parietariae, compositae, Alternaria, and Cladosporium. One hundred patients with a history of allergy were enrolled at two study sites.

At the first visit, each patient received a diary to record medication use and efficacy and two masked bottles of the drugs.

They were instructed to use both medications as needed for 4 weeks but not to exceed two drops per eye each day. At the second visit at the end of the fourth week, patients filled out a brief questionnaire comparing the two drugs for patient preference, comfort, and effectiveness.

Patient preference

"The patients reported a significant preference for using olopatadine, with 81% indicating this preference, 17% preferring ketotifen, and 2% indicating no preference," the investigators reported.

More specifically, when the patients were asked which drug provided better symptom relief, 81% chose olopatadine and 19% ketotifen; 81% also said that olopatadine was more comfortable than ketotifen, while 18% chose ketotifen and 1% claimed that they had no preference.

When asked which drug they might ask for in a physician's office, 81% said olopatadine and 18% ketotifen, while 1% had no preference.

Finally, the last question asked patients to consider how they determined their drug preference, and 76% responded that their choice was based on both efficacy and comfort, which was significantly greater than the 6% who considered comfort alone and the 18% who considered efficacy alone. The differences for all comparisons were significant at p < 0.0001.

"Objective evaluation of eye-drop efficacy, while important, is not the only factor in determining the optimal therapy for patient care. The comfort, convenience, and patient perception of efficacy are also defining factors in selection. In this study, most patients indicated that they evaluated both efficacy and comfort in deciding between two treatments," the authors stated.

The authors' findings confirm those of previous studies of the two drugs for both efficacy and comfort.

"Olopatadine is a well-tolerated and effective drug for all forms of ocular allergy. No serious side effects have been reported by the numerous patients treated every day in clinical practice. For its efficacy and comfort, olopatadine can be considered the first-choice treatment for patients with ocular allergies," Dr. Leonardi said.