Eyeworld Supplements

itching, Dr. Lane said. There are a number of ways to treat this bother- some symptom, such as allergen avoidance, cold compresses, over-the- counter medications, lubricants, and prescription drugs such as mast cell stabilizers and/or antihistamines, topical steroids, and NSAIDs. "The most popular way [to treat ocular allergies] is with a dual action antihistamine and mast cell stabilizer," Dr. Lane said, such as Bepreve (bepotastine besilate, ISTA Pharma- ceuticals), which Dr. Lane gave the clinical trial results of. The Bepreve clinical trials utilized a Conjunctival Allergen Challenge (CAC) and included two randomized placebo-controlled studies with single- site and multi-site type characteristics. Patients with allergic conjunctivitis history underwent CAC testing. CAC testing meant patients were dosed with either the active agent (Bepreve) or a placebo and then introduced to an allergen. Symptoms of ocular itching were measured at 3, 5, and 7 minutes, and symptoms of conjunctival hyper- emia were measured at 7, 15, and 20 minutes (Figure 4). "In terms of the onset of action, there was a very quick onset of reaction of Bepreve compared to the placebo," Dr. Lane said. "If you look at the long-lasting effect of this in terms of relief of itch, once again there's statistically significant relief, up to 8 and prevalence have increased in the past 40 years. "Forty percent of the U.S. popula- tion had ocular allergy symptoms at some point in the last year," he said. "Twenty percent missed work due to these incidents, and 45% reported decreased productivity due to allergic eye disease. Patients with seasonal allergic conjunctivitis have decreased vision and a decreased quality of life. It's estimated that its impact on healthcare cost is $6 billion annually." The most common forms of aller- gic eye disease are seasonal allergic conjunctivitis (SAC) and perennial allergic conjunctivitis (PAC), which make up about 95% of the allergic conjunctivitis population. The remain- ing 5% have less common but more serious conditions such as vernal keratoconjunctivitis, atopic keratocon- junctivitis, giant papillary conjunctivitis, or phlyctenular keratoconjunctivitis. It's with these conditions that patients have the greatest risk of vision loss. "No matter what type of oph- thalmic practice you have, these conditions affect patients' quality of life, their visual acuity, and our surgical outcomes," Dr. Holland said. Building upon the information Dr. Holland provided was Dr. Lane with a talk on the efficacy, safety, comfort, and cost considerations for treatment of allergic conjunctivitis. The hallmark indicator of allergic conjunctivitis is hours [with Bepreve]. If you took those patients who had a severe response, you can see that 68% of those patients had relief of severe symptoms with Bepreve [but] essentially none with the placebo" (Figures 5 and 6). In regard to adverse events when taking Bepreve, dry eye was reported in about 2% of the placebo-treated patients and 1% of the Bepreve- treated patients, Dr. Lane said. Finally, Dr. Lane stressed the tremendous value Bepreve provides patients, which is "important in this day and age when the economics of the medications we use are under such high scrutiny." Bepreve is supplied in 10 mL bottles, which allows for one copay for a 60-day period and means fewer trips to the pharmacy. "The combination provides for greater value as you consider the refill costs of this as [patients] continue to have symptoms throughout the year or at various times during the year," Dr. Lane said. "We have a medication that's effective, we have a medication that is safe, and we have a medication that is of great value to the patient," Dr. Lane said. "I think this combination lends this to be a very effective compound to be used in allergic conjunctivitis" (Figure 7). Dr. Lindstrom gave his unique view on ocular allergies from both a clinician's and a patient's perspective, 2 July 2012 Figure 2 Figure 3 Improving the treatment of ocular allergies ISTA supplement_EW July 2012-DL2_Layout 1 6/3/14 2:44 PM Page 3

• Cover