Combination of 0.05% Azelastine and 0.1% Tacrolimus Eye Drops in Children With Vernal Keratoconjunctivitis: A...

Area of Science:

• Ophthalmology
• Pediatric Allergy & Immunology

Background:

• Vernal keratoconjunctivitis (VKC) is a severe allergic eye disease affecting children.
• Current treatments for VKC, such as topical corticosteroids, have potential side effects.
• Tacrolimus is an effective immunomodulator for VKC, but its efficacy can be enhanced.

Purpose of the Study:

• To compare the efficacy of combined 0.05% azelastine and 0.1% tacrolimus eye drops versus 0.1% tacrolimus monotherapy.
• To evaluate treatment outcomes in pediatric patients diagnosed with VKC.
• To assess improvements in ocular surface disease index (OSDI) and clinical signs of VKC.

Main Methods:

• A prospective randomized controlled trial involving 76 pediatric VKC patients.
• Patients were assigned to either 0.1% tacrolimus monotherapy or a combination of 0.05% azelastine and 0.1% tacrolimus.
• Ocular assessments included OSDI scores, conjunctival hyperemia, corneal involvement, and papillae at baseline and at 1, 2, and 6 weeks.

Main Results:

• Both treatment groups showed significant improvements in OSDI scores and clinical VKC signs (p < 0.001).
• The combination therapy group demonstrated a significantly greater reduction in OSDI scores at 1 week (p=0.0085).
• Combination therapy led to superior improvements in conjunctival hyperemia and papillae (p < 0.05) and reduced corneal involvement at 2 weeks (p=0.0488) compared to monotherapy.

Conclusions:

• The combination of 0.05% azelastine and 0.1% tacrolimus eye drops provides faster and more significant clinical improvements in pediatric VKC.
• This combination therapy is a promising alternative for managing VKC in children, offering enhanced efficacy over tacrolimus monotherapy.
• No severe adverse effects were reported, suggesting a favorable safety profile for the combination treatment.