Once daily dosing of bromfenac ophthalmic solution 0.09% for postoperative ocular inflammation and pain

Abstract

Objective:

To evaluate the efficacy and ocular safety of bromfenac ophthalmic solution 0.09% dosed once daily for the treatment of ocular inflammation and pain following cataract extraction with posterior chamber intraocular lens implantation.

Methods:

A total of 455 subjects (455 study eyes: 230 bromfenac, 225 placebo) were enrolled in two randomized double-masked, placebo-controlled, clinical trials at 64 ophthalmology clinics in the United States. Subjects were randomized to receive either bromfenac 0.09% or placebo dosed once daily. Dosing began 1 day before cataract surgery (Day -1), continued on day of surgery (Day 0), and for 14 days following surgery. Evaluations were completed on Days 1, 3, 8, 15 and 22. The primary efficacy endpoint was cleared summed ocular inflammation score (SOIS) by Day 15. The secondary efficacy endpoint was the number of subjects who were pain-free at Day 1.

Results:

The bromfenac 0.09% group was significantly higher compared to the placebo group in the primary endpoint of the proportion of subjects who had cleared ocular inflammation by Day 15 (P < 0.0001). The mean SOIS for the bromfenac 0.09% group was lower than the placebo group at Days 3, 8, 15, and 22 (P < 0.0001). More bromfenac 0.09% subjects were pain free at Days 1, 3, 8, and 15 (P < 0.0001). Fewer subjects in the bromfenac 0.09% group withdrew from the clinical trials due to lack of efficacy at Day 15 (P < 0.0001). Fewer adverse events were reported in the bromfenac 0.09% group than the placebo group. Limitations included advanced age, female predominance, and surgical nuances among cataract surgeons, making cross-trial comparisons difficult.

Conclusions:

Bromfenac ophthalmic solution 0.09% dosed once daily is clinically safe and effective for the treatment of ocular inflammation and the reduction of ocular pain associated with cataract surgery.

Trial registration: ClinicalTrials.gov identifier: NCT00704418.

Trial registration: ClinicalTrials.gov identifier: NCT00853970.

Key words::

• Bromfenac
• Cataract surgery
• Non-steroidal anti-inflammatory
• Ocular inflammation
• Ocular pain
• Ophthalmic

Transparency

Declaration of funding

Clinical trial support was provided by ISTA Pharmaceuticals, Inc., Irvine, CA, USA. The sponsor participated in the design of the clinical trials, data collection, data management, data analyses, interpretation of the data, preparation, review, and approval of the manuscript.

Declaration of financial/other relationships

S.M.S., M.G.C., E.S., J.H.P., and R.F. were principal investigators for ISTA Pharmaceuticals, Inc. and have been consultants/speakers for ISTA Pharmaceuticals, Inc. S.P.C., J.A.G., S.M.K., and T.R.M. are employees of ISTA Pharmaceuticals, Inc.

Acknowledgments

The authors wish to thank the investigators who participated in the clinical trials described in the manuscript; Mauricio Muñoz, PharmD and Randi L. Rohlman, BS of ISTA Pharmaceuticals, Inc., Irvine, CA, USA for data review and verification; and Robin Whitsell, BA, BPh, Ann Winter-Vann, PhD, Christine Conwell, PhD of Whitsell Innovations, Inc., Chapel Hill, NC, USA and Patrick Ho, PharmD, West Virginia University/ISTA Pharmaceuticals, Inc. Medical Affairs Fellow for their editorial assistance with scientific content. ISTA Pharmaceuticals, Inc. provided funding for the editorial assistance with scientific content by Whitsell Innovations.

Members of Bromfenac Ophthalmic Solution Once Daily (Bromday) Study Group are listed in the Appendix.

Presented in part at the 2010 American Academy of Ophthalmology (AAO) Annual Meeting, Chicago, IL, USA, October 16–19, 2010.

Notes

* Bronuck is a registered trade name of Senju Pharmaceutical Company, Ltd, Osaka, Japan.

† Xibrom is a registered trade name of ISTA Pharmaceuticals, Inc., Irvine, CA, USA.

* Bromday is a registered trade name of ISTA Pharmaceuticals, Inc., Irvine, CA, USA.