Cyclo-oxygenase Inhibitors in the Treatment of Chronic Non-infectious, Non-necrotizing Scleritis and Episcleritis

Abstract

Purpose: To evaluate the use of selective vs. non-selective cyclo-oxygenase inhibitors (COXIs) for the treatment of chronic non-infectious, non-necrotizing scleritis and episcleritis.

Methods: Sixty-nine patients with scleritis and episcleritis treated for ≥2 months with COXIs were included. Outcome measures were rates of inflammation control, corticosteroid sparing, and COXI discontinuation, as well as side effects.

Results: Initial inflammation control was achieved in 78–81% of scleritis patients and 73–80% episcleritis patients on COXIs (p > .05). Rates of steroid sparing after 4–24 months of consecutive treatment were similar. Gastrointestinal side effects were observed in 1 (2.7%) patient on selective vs. 3 (9.4%) patients on non-selective COXIs (p = .33). Overall discontinuation rate was 6/37 (16%) for selective vs. 7/32 (22%) for non-selective COXIs (p = .76).

Conclusions: Selective vs. non-selective COXIs were equally efficacious for the treatment of chronic non-infectious, non-necrotizing scleritis and episcleritis. Prospective studies to elucidate potential differences in side effect profiles may be warranted.

KEYWORDS::

• Corticosteroids
• cyclo-oxygenase inhibitors
• episcleritis
• inflammation
• scleritis

Declaration of interest: This study was supported by an unrestricted grant from Research to Prevent Blindness (DSC).