Cyclosporine emulsion holds potential in vernal keratoconjunctivitis

Use of cyclosporine A cationic emulsion (CsA CE) 0.1% eye drops in the treatment of patients with severe active vernal keratoconjunctivitis (VKC) is safe and yields improvements in keratitis, symptoms and quality of life (QoL) that are maintained for up to 8 months, according to the results of a trial.

The trial initially randomized 169 patients (age range, 4–17 years) in the 4-month VEKTIS study, among whom 142 entered the 8-month follow-up period. During the follow-up, CsA CE-treated patients remained on their original regimen—CsA CE four times daily (QID, high-dose) or CsA CE twice daily (BID, low-dose) plus vehicle BID—while vehicle-treated patients were allocated to one of these two active regimens.

Compared with those in the vehicle group, patients in the CsA CE groups showed greater improvements in main efficacy measures, including corneal fluorescein staining (CFS) score rescue medication use, key VKC symptoms (photophobia, tearing, itching and mucous discharge), and QoL (assessed by QUICK questionnaire) during the 4-month evaluation period.

The improvements observed with CsA CE remained stable over the 8-month follow-up, with the beneficial effects on most efficacy measures consistently greater with the high-dose regimen.

CsA CE had a favourable safety profile. Overall, treatment-related, treatment-emergent adverse events occurred in 15 (20.8 percent) and 11 (15.7 percent) of the CsA CE high-dose and low-dose patients, respectively. The most frequently reported event was instillation site pain (13.9 percent and 7.1 percent, respectively).