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Topical ciclosporin in the treatment of vernal keratoconjunctivitis in Rwanda, Central Africa: a prospective, randomised, double-masked, controlled clinical trial

Stefan De Smedt, John Nkurikiye, Yannick Fonteyne, Stephen Tuft, Dirk De Bacquer UGent, Clare Gilbert and Philippe Kestelyn UGent (2012) BRITISH JOURNAL OF OPHTHALMOLOGY. 96(3). p.323-328
abstract
Aim To compare the short-term efficiency and safety of topical ciclosporin A (CsA) 2% with dexamethasone 0.1% in the treatment of predominantly limbal vernal keratoconjunctivitis (VKC) in Rwanda, Central Africa. Methods Consecutive patients with VKC were randomised in a prospective, double-masked, clinical trial to receive either topical CsA 2% dissolved in olive oil vehicle or dexamethasone 0.1% drops for 4 weeks. Both groups then received sodium chromoglycate 2% drops for maintenance therapy for a further 4 weeks. The primary outcome was the reduction in composite score for VKC-related symptoms and signs at 4 weeks. Secondary outcomes included side effects, best-corrected visual acuity, comfort rating of the trial drops during 4 weeks' test medication and relapse rate thereafter. Results The 366 participants recruited had the limbal (91.5%) or mixed form of VKC. At the end of the 4-week treatment period, the composite score had decreased significantly (p < 0.001) from baseline without any significant difference between CsA and dexamethasone (p = 0.20). There were no severe adverse reactions, but CsA drops caused more stinging than the oil placebo and dexamethasone (p < 0.001). In both treatment groups, the visual acuity had improved at 4 weeks compared with baseline (p < 0.001) with no significant difference between the treatment arms. The relapse rate following cessation of the trial treatments was similar (p = 0.84) in both groups. Conclusion There is no significant difference between the efficiency of topical CsA 2% and dexamethasone 0.1% for the management of acute VKC in Central Africa, but tolerance needs to be improved.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
EYEDROPS, MANAGEMENT, 0.05-PERCENT, SAFETY, EFFICACY, CASE SERIES, ALLERGIC CONJUNCTIVITIS, ATOPIC KERATOCONJUNCTIVITIS
journal title
BRITISH JOURNAL OF OPHTHALMOLOGY
Br. J. Ophthalmol.
volume
96
issue
3
pages
323 - 328
Web of Science type
Article
Web of Science id
000300604900004
JCR category
OPHTHALMOLOGY
JCR impact factor
2.725 (2012)
JCR rank
9/58 (2012)
JCR quartile
1 (2012)
ISSN
0007-1161
DOI
10.1136/bjophthalmol-2011-300415
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
2097065
handle
http://hdl.handle.net/1854/LU-2097065
date created
2012-05-02 13:22:15
date last changed
2015-06-17 10:01:55
@article{2097065,
  abstract     = {Aim To compare the short-term efficiency and safety of topical ciclosporin A (CsA) 2\% with dexamethasone 0.1\% in the treatment of predominantly limbal vernal keratoconjunctivitis (VKC) in Rwanda, Central Africa. 
Methods Consecutive patients with VKC were randomised in a prospective, double-masked, clinical trial to receive either topical CsA 2\% dissolved in olive oil vehicle or dexamethasone 0.1\% drops for 4 weeks. Both groups then received sodium chromoglycate 2\% drops for maintenance therapy for a further 4 weeks. The primary outcome was the reduction in composite score for VKC-related symptoms and signs at 4 weeks. Secondary outcomes included side effects, best-corrected visual acuity, comfort rating of the trial drops during 4 weeks' test medication and relapse rate thereafter. 
Results The 366 participants recruited had the limbal (91.5\%) or mixed form of VKC. At the end of the 4-week treatment period, the composite score had decreased significantly (p {\textlangle} 0.001) from baseline without any significant difference between CsA and dexamethasone (p = 0.20). There were no severe adverse reactions, but CsA drops caused more stinging than the oil placebo and dexamethasone (p {\textlangle} 0.001). In both treatment groups, the visual acuity had improved at 4 weeks compared with baseline (p {\textlangle} 0.001) with no significant difference between the treatment arms. The relapse rate following cessation of the trial treatments was similar (p = 0.84) in both groups. 
Conclusion There is no significant difference between the efficiency of topical CsA 2\% and dexamethasone 0.1\% for the management of acute VKC in Central Africa, but tolerance needs to be improved.},
  author       = {De Smedt, Stefan and Nkurikiye, John and Fonteyne, Yannick and Tuft, Stephen and De Bacquer, Dirk and Gilbert, Clare and Kestelyn, Philippe},
  issn         = {0007-1161},
  journal      = {BRITISH JOURNAL OF OPHTHALMOLOGY},
  keyword      = {EYEDROPS,MANAGEMENT,0.05-PERCENT,SAFETY,EFFICACY,CASE SERIES,ALLERGIC CONJUNCTIVITIS,ATOPIC KERATOCONJUNCTIVITIS},
  language     = {eng},
  number       = {3},
  pages        = {323--328},
  title        = {Topical ciclosporin in the treatment of vernal keratoconjunctivitis in Rwanda, Central Africa: a prospective, randomised, double-masked, controlled clinical trial},
  url          = {http://dx.doi.org/10.1136/bjophthalmol-2011-300415},
  volume       = {96},
  year         = {2012},
}

Chicago
De Smedt, Stefan, John Nkurikiye, Yannick Fonteyne, Stephen Tuft, Dirk De Bacquer, Clare Gilbert, and Philippe Kestelyn. 2012. “Topical Ciclosporin in the Treatment of Vernal Keratoconjunctivitis in Rwanda, Central Africa: a Prospective, Randomised, Double-masked, Controlled Clinical Trial.” British Journal of Ophthalmology 96 (3): 323–328.
APA
De Smedt, Stefan, Nkurikiye, J., Fonteyne, Y., Tuft, S., De Bacquer, D., Gilbert, C., & Kestelyn, P. (2012). Topical ciclosporin in the treatment of vernal keratoconjunctivitis in Rwanda, Central Africa: a prospective, randomised, double-masked, controlled clinical trial. BRITISH JOURNAL OF OPHTHALMOLOGY, 96(3), 323–328.
Vancouver
1.
De Smedt S, Nkurikiye J, Fonteyne Y, Tuft S, De Bacquer D, Gilbert C, et al. Topical ciclosporin in the treatment of vernal keratoconjunctivitis in Rwanda, Central Africa: a prospective, randomised, double-masked, controlled clinical trial. BRITISH JOURNAL OF OPHTHALMOLOGY. 2012;96(3):323–8.
MLA
De Smedt, Stefan, John Nkurikiye, Yannick Fonteyne, et al. “Topical Ciclosporin in the Treatment of Vernal Keratoconjunctivitis in Rwanda, Central Africa: a Prospective, Randomised, Double-masked, Controlled Clinical Trial.” BRITISH JOURNAL OF OPHTHALMOLOGY 96.3 (2012): 323–328. Print.