title: Efficacy of epinastine hydrochloride ophthalmic solution in allergic conjunctivitis by conjunctival cedar pollen allergen challenge.
abstract: BACKGROUND
  Epinastine hydrochloride is a selective histamine H1 receptor antagonist that also inhibits IgE receptor-mediated histamine release from mast cells.
  
  
  OBJECTIVE
  To show the superiority of epinastine 0.05% ophthalmic solution (epinastine) to placebo ophthalmic solution (placebo) and noninferiority to olopatadine 0.1% ophthalmic solution (olopatadine) for cedar pollen antigen-induced ocular itching and conjunctival hyperemia.
  
  
  METHODS
  The study was conducted in ophthalmologically asymptomatic adult volunteers with seasonal allergic conjunctivitis using a conjunctival allergen challenge test. Subjects were randomized into 3 groups (n = 87) to evaluate superiority to placebo (visits 4 to 6) and 2 groups (n = 86) to evaluate noninferiority to olopatadine (visit 7). At each visit, a single administration of the study medication was instilled at 15 minutes (visit 4), 4 hours (visit 5), 8 hours (visit 6), and 4 hours (visit 7) before the conjunctival allergen challenge test. Ocular itching and conjunctival hyperemia of allergic conjunctivitis were assessed after the conjunctival allergen challenge test.
  
  
  RESULTS
  For the primary end point, epinastine showed superiority to placebo for the inhibition of ocular itching and conjunctival hyperemia induced at 4 hours after the dose (equivalent to 4-times-daily dosing). For the secondary end points, epinastine significantly inhibited itching and conjunctival hyperemia induced at 15 minutes and 8 hours after the dose (equivalent to 2-times-daily dosing) compared with placebo. In addition, epinastine demonstrated noninferiority to olopatadine for ocular itching and conjunctival hyperemia. No adverse drug reactions or serious adverse events were reported throughout the study, indicating that epinastine has a good safety profile.
  
  
  CONCLUSIONS
  Epinastine is effective and safe for the treatment of allergic conjunctivitis.
  
  
  BACKGROUND
  Clinicaltrials.gov identifier NCT01363700.
authors.affiliation: Department of Ophthalmology, Tsurumi University School of Dental Medicine, Kanagawa, Japan. Electronic address: fujishima117@gmail.com.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Fujishima
authors.affiliation: Department of Ophthalmology, Ehime University School of Medicine, Ehime, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Ohashi
authors.affiliation: Department of Ophthalmology, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.
authors.forename: Etsuko
authors.initials: E
authors.lastname: Takamura
mesh_terms: D000328:Adult; D000485:Allergens / Q000276:immunology; D018926:Anti-Allergic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D028203:Cedrus / Q000276:immunology; D003228:Conjunctiva / Q000276:immunology; D003233:Conjunctivitis, Allergic / Q000188:drug therapy*; D003984:Dibenzazepines / Q000009:adverse effects / Q000627:therapeutic use*; D003990:Dibenzoxepins / Q000627:therapeutic use; D005260:Female; D006634:Histamine H1 Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D006940:Hyperemia / Q000188:drug therapy / Q000517:prevention & control; D007093:Imidazoles / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D000069605:Olopatadine Hydrochloride; D009883:Ophthalmic Solutions / Q000009:adverse effects / Q000627:therapeutic use*; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D011058:Pollen / Q000276:immunology; D006255:Rhinitis, Allergic, Seasonal / Q000188:drug therapy; D055815:Young Adult
chemical_list: D000485:Allergens; D018926:Anti-Allergic Agents; D003984:Dibenzazepines; D003990:Dibenzoxepins; D006634:Histamine H1 Antagonists; D007093:Imidazoles; D009883:Ophthalmic Solutions; D010975:Platelet Aggregation Inhibitors; D000069605:Olopatadine Hydrochloride; C053090:epinastine