0.5% Loteprednol etabonate and 0.3% tobramycin combo safe against ocular inflammatory diseases

In a new study conducted by James Deom and peers it was shown that when utilized to treat different ocular surface inflammatory disorders found in optometric practice, loteprednol etabonate 0.5% and tobramycin 0.3% (LE/T) appears to have a good level of safety. The findings of this study were published in Clinical Ophthalmology.

In ocular surface inflammatory disorders when corticosteroid therapy is recommended and there is a risk of superficial bacterial infection, the use of a combined corticosteroid and antibiotic medication is widespread. Topical corticosteroids have well-established effectiveness in the therapy of ocular inflammation, but they also have possible side effects such as increased intraocular pressure (IOP). Loteprednol etabonate 0.5% + tobramycin 0.3% is an ocular solution that combines a topical corticosteroid (loteprednol etabonate; LE) with an aminoglycoside antibiotic (tobramycin; T). As a result, this research was planned as a retrospective record review to evaluate the real-world usage of LE/T in patients with ocular surface inflammatory diseases, with a focus on dosage regimens, IOP and other safety outcomes, and clinical illness remission.

Three optometrist offices in the USA underwent a retrospective chart review for this project. Data were gathered from cases where LE/T was used, and data were kept during the time period starting with therapy with at least one follow-up appointment (within 2 months). Patient demographics, diagnosis, LE/T dosage, pre- and post-treatment ocular symptoms and signs intraocular pressure readings, adverse event (AE) reports, visual acuity (VA), and any notes on the resolution of baseline condition were all included in the data that was abstracted. IOP changes and AEs were the main outcomes that were of interest.

The key findings of this study were:

1. Data from 87 patient charts (115 LE/T-treated eyes) were included in the 96 patient charts that were retrieved.

2. The majority of patients (83.9%) were white, and slightly over half of them were female (58.6%), with a mean age (SD) of 45.6 (19.7).

3. Conjunctival injury/corneal abrasion (25.3%), viral conjunctivitis (16.1%), keratitis (18.4%), and blepharitis/eyelid inflammation/MGD (11.5%) were common baseline conditions. One drop QID was the most typical dosage for LE/T.

4. At baseline, the mean (SD) IOP was 15.2 mm Hg, and at the initial follow-up appointment, it was 15.7 mm Hg (p = 0.2467).

5. No AEs were reported, and the mean VA did not change significantly.

6. When indicated, the majority of patients (83%) had their disease cured at the first or second follow-up appointment.

In conclusion, this retrospective case evaluation offers a clinically relevant window into the practical application of LE/T in a variety of potentially infectious inflammatory ocular surface diseases. When utilized for the treatment of different ocular surface inflammatory disorders seen in optometric therapy, LE/T seems to have a good level of safety.

Reference:

Deom, J. E., Kannarr, S., & Vollmer, P. (2022). Real-World Use of Loteprednol Etabonate 0.5%/Tobramycin 0.3% Ophthalmic Suspension for the Treatment of Ocular Surface Inflammatory Conditions. In Clinical Ophthalmology: Vol. Volume 16 (pp. 3803–3809). Informa UK Limited. https://doi.org/10.2147/opth.s389688