Drug's multimodal mechanisms of action provide rapid relief for ocular symptoms

Belleville, NJ-Azelastine HCl ophthalmic solution 0.05% (Optivar, MedPointe Pharmaceuticals) offers safe and effective relief of ocular symptoms associated with seasonal/intermittent and perennial/persistent allergic conjunctivitis. In addition, the treatment is an important adjuvant in patients with allergic rhinoconjunctivitis who may be receiving oral or intranasal medication to control their rhinitis, said John Favetta, MD.

Allergic rhinoconjunctivitis is a highly prevalent condition, said Dr. Favetta, director of ophthalmology, Clara Maas Medical Center, Belleville, NJ, and West Hudson Hospital, Kearny, NJ. Between 25% and 40% of the U.S. population is affected by the condition that accounts for 80% to 90% of all allergic disorders. About 80% of people afflicted with rhinitis have allergic conjunctivitis as well; about the same proportion of those individuals consider their ocular symptoms at least as severe as their nasal symptoms. Especially noteworthy is the fact that about 90% of rhinitis patients who currently are taking oral or intranasal treatment for their condition still have ocular symptoms.

"As ophthalmologists, we tend to focus on the eye," said Dr. Favetta. "We need to consider how the allergic condition is affecting the whole patient, recognize that existing oral or intranasal treatment for rhinitis still may leave the patient with residual ocular symptoms, and in the case of oral antihistamines, perhaps even worsen it by causing ocular surface drying."

Azelastine can be used safely and effectively in children as young as 3 years, Dr. Favetta said. The product has a long duration of activity and so offers a convenient twice-daily dosing schedule for adults and pediatric patients, he added.

"Because azelastine affects the early and late phases of the allergic reaction, once a steady state level is achieved, it is often possible to reduce the dosing frequency to just once daily and still maintain control of the allergic symptoms," he noted.

Azelastine is very well-tolerated and has the unique benefit of being formulated with the lubricating agent hypromellose (hydroxypropyl methylcellulose), Dr. Favetta said.

"Incorporating this lubricant makes azelastine a very comfortable drop to use, although a small percentage of patients may complain of a stinging sensation on instillation," he said. "It has an added benefit in patients who are taking an oral antihistamine. Even the newer non-sedating antihistamines can cause ocular surface drying. Hypromellose in the azelastine formulation effectively takes care of that problem."