title: Loteprednol etabonate in the treatment of allergic conjunctivitis: a meta-analysis.
abstract: OBJECTIVE
  This meta-analysis was designed to assess the efficacy, as well as the safety of loteprednol etabonate (LE) ophthalmic suspension compared with placebo and other commonly used eye drops for treatment of allergic conjunctivitis.
  
  
  METHODS
  Comprehensive searches of randomized controlled trials were carried out in a database of Medline, Embase, and the Cochrane Library. Eight qualified studies were included. This study assessed the reduction from baseline in scores of cardinal signs and symptoms, proportion of patients with improvement of allergic signs and symptoms, and incidence of clinically significant intraocular pressure (IOP) elevation (IOP elevation ≥10 mmHg).
  
  
  RESULTS
  The results showed that topical LE was significantly superior to placebo in reduction from baseline in signs scores (standardized mean difference [SMD] = -0.48; 95% confidence interval [CI] = -0.65 to -0.32) and symptoms scores (weighted mean difference [WMD] = -0.51; 95% CI = -0.64 to -0.38) of allergic conjunctivitis, and as effective as olopatadine and fluorometholone acetate. Topical LE was associated with a higher improvement rate of signs (risk ratio [RR] = 1.53; 95% CI = 1.26-1.86; I (2 )= 57%) and symptoms (RR = 1.29; 95% CI = 1.15-1.46; I (2 )= 54%) than placebo and the positive control treatment. Clinically significant IOP elevation was more frequent in the group of LE than the group of control treatment (pooled odds ratio = 3.03; 95% CI = 1.04-8.80), which was affected by the response to corticosteroid of the individual patient and the wearing of contact lenses.
  
  
  CONCLUSIONS
  Topical LE is effective in treating allergic conjunctivitis. However, it should be used with caution due to the higher incidence of IOP elevation compared with placebo and olopatadine. A large-scale trial would be required to confirm the effect of different concentrations of LE on IOP.
authors.affiliation: a a Department of Ophthalmology , Shanghai Changzheng Hospital, Second Military Medical University , Shanghai , PR China.
authors.forename: Lian-Qun
authors.initials: LQ
authors.lastname: Wu
authors.forename: Xu
authors.initials: X
authors.lastname: Chen
authors.forename: Heng
authors.initials: H
authors.lastname: Lou
authors.forename: Jin-Wei
authors.initials: JW
authors.lastname: Cheng
authors.forename: Rui-Li
authors.initials: RL
authors.lastname: Wei
mesh_terms: D018926:Anti-Allergic Agents / Q000627:therapeutic use*; D003233:Conjunctivitis, Allergic / Q000188:drug therapy*; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects; D000069559:Loteprednol Etabonate / Q000009:adverse effects / Q000627:therapeutic use*; D000069605:Olopatadine Hydrochloride / Q000627:therapeutic use; D017594:Publication Bias
chemical_list: D018926:Anti-Allergic Agents; D000069605:Olopatadine Hydrochloride; D000069559:Loteprednol Etabonate
keywords: Allergic conjunctivitis; Efficacy; Intraocular pressure; Loteprednol etabonate; Meta-analysis; Safety