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TitelTopical ciclosporin in the treatment of vernal keratoconjunctivitis in Rwanda, Central Africa: a randomised, double-masked, controlled clinical trial
DoelTo compare the short-term efficacy and safety of topical ciclosporin A (CsA) 2% with dexamethasone 0.1% in the treatment of predominantly limbal VKC in Rwanda.
MethodesConsecutive patients with VKC were randomised in a prospective, double-masked, clinical trial to receive either topical CsA 2% dissolved in olive oil vehicle or dexamethasone 0.1% drops for 4 weeks. Both groups then received sodium chromoglycate 2% drops for maintenance therapy for a further 4 weeks. The primary outcome was the reduction in composite score for VKC-related symptoms and signs at 4 weeks. Secondary outcomes included side effects, comfort rating of the trial drops during 4 weeks test medication, and relapse rate thereafter.
ResultatenThe 366 participants recruited had the limbal (91.5%) or mixed form of VKC. At the end of the 4 week treatment period the composite score had significantly (p<0.001) reduced from baseline without a significant difference between CsA and dexamethasone (p= 0.20).There were no severe adverse reactions but CsA drops caused more stinging than the oil placebo and dexamethasone (p<0.001). The relapse rate following cessation of the trial treatments was similar (p= 0.84) in both groups.
ConclusieThere is no significant difference between the efficacy of topical CsA 2% and dexamethasone 0.1% for the management of acute VKC in Central Africa, but tolerance needs to be improved.
Auteur 1
NaamDE SMEDT
InitialenSK
InstituutOphthalmology Department, Ghent University Hospital
StadGent
Auteur 2
NaamNKURIKIYE
InitialenJ
InstituutOphthalmology Department, King Faisal Hospital
StadKigali, Rwanda
Auteur 3
NaamFONTEYNE
InitialenY
Instituut Kabgayi Hospital
StadMuhanga, Rwanda
Auteur 4
NaamTUFT
InitialenS
InstituutMoorfields Eye Hospital NHS Foundation Trust
StadLondon, UK
Auteur 5
NaamDE BACQUER
InitialenD
InstituutPublic Health Department, Ghent University Hospital
StadGent
Auteur 6
NaamGILBERT
InitialenC
InstituutInternational Centre for Eye Health
StadLondon, UK
Auteur 7
NaamKESTELYN
InitialenP
InstituutOphthalmology Department, Ghent University Hospital
StadGent
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