Pharmacokinetic evaluation of topical calcineurin inhibitors for treatment of allergic conjunctivitis.
BACKGROUND
Topical calcineurin (Cn) inhibitors delivered via ophthalmic drop is emerging as a potential treatment for severe, immune-mediated forms of allergic conjunctivitis, such as vernal keratoconjunctivitis, atopic keratoconjunctivitis and giant papillary conjunctivitis.


METHODS
This article is based on a comprehensive literature search, with information taken from meta-analyses, systematic reviews, treatment guidelines and clinical studies in children and adults. The articles that have been selected evaluate the use of topical Cn inhibitors and their role in the treatment of allergic conjunctivitis.


CONCLUSIONS
Ophthalmic topical Cn inhibitors have been shown to be safe for short-term use, with minimal systemic absorption and toxicity. For patients with severe, refractory forms of allergic conjunctivitis, topical Cn inhibitors offer a promising treatment option and an alternative to steroidal therapies. The safety profile and efficacy data for topical cyclosporine are more robust compared to that of tacrolimus and pimecrolimus, although larger trials will be needed for all three agents. With more randomized controlled trials involving larger sample sizes and long-term follow-up to establish both efficacy and safety, ophthalmic Cn inhibitors offer exciting treatment possibilities for the prevention of morbidity associated with refractory allergic conjunctivitis.
University of Chicago, Department of Internal Medicine , 5841 South Maryland Ave MC 7082, Chicago, IL 60637 , USA.
Xiao Chloe
XC
Wan
Vesselin
V
Dimov
D060433:Administration, Ophthalmic; D065095:Calcineurin Inhibitors; D003233:Conjunctivitis, Allergic / Q000188:drug therapy*; D016572:Cyclosporine / Q000493:pharmacokinetics* / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000493:pharmacokinetics* / Q000627:therapeutic use; D016559:Tacrolimus / Q000031:analogs & derivatives* / Q000493:pharmacokinetics* / Q000627:therapeutic use; D016896:Treatment Outcome
D065095:Calcineurin Inhibitors; D007166:Immunosuppressive Agents; C117268:pimecrolimus; D016572:Cyclosporine; D016559:Tacrolimus