Flurbiprofen: A Nonselective Cyclooxygenase (COX) Inhibitor for Treatment of Noninfectious, Non-necrotizing Anterior Scleritis

Abstract

Objective: To analyze the safety and efficacy of a nonselective cyclo-oxygenase (COX) inhibitor in the management of noninfectious, non-necrotizing anterior scleritis.

Methods: Retrospective chart review of 126 patients with non-necrotizing anterior scleritis treated with oral flurbiprofen (Froben®(Abbott Healthcare)) with (Group B, n = 61) or without (Group A, n = 65) topical steroids was performed and time to remission was plotted.

Results: The observed incidence rate was 1.07 (95% CI: 0.57–1.99) per 1000 person-years with failure rate of 0.68 (95% CI: 0.22–2.12) per 1000 person-years in Group A and 1.41 (95% CI: 0.67–2.96) per 1000 person-years in Group B. The failure rate was 3.97 (1.89–9.34) per 1000 person-years with hazard ratio of 10.01 (95% CI: 2.52–39.65; p < 0.001) for patients with associated systemic disease.

Conclusion: To the of our best knowledge, this is the first and largest case series on the safety and efficacy of a nonselective COX inhibitor in the management of anterior scleritis.

• COX-inhibitor
• flurbiprofen
• froben
• noninfective
• non-necrotizing scleritis
• oral NSAIDs

Acknowledgements

This work was supported by the National Institute for Health Research (NIHR) Biomedical Research Centre based at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.” JJGL is a PhD candidate at the Departamento de Cirugía, Facultad de Medicina, Universidad de Alcalá, Madrid, Spain. Dr Rupesh Agrawal is sponsored by National Medical Research Council Singapore for overseas research training fellowship.

Declaration of interest

The authors report no conflict of interest. The authors alone are responsible for the content and writing of the paper.

JJGL has received study grants from Alcon, Novartis, and MSD, and has provided unpaid consultancy to Bayer. RA is on a NMRC overseas research training fellowship at Institute of Ophthalmology and Moorfields Eye Hospital, London.

Authors’ contributions

SK and VR collated all the data and contributed to the first draft of the manuscript. RA wrote the first draft of the manuscript and performed statistical analysis. RA, JJGL, and CL edited the draft, did literature review, and were involved in intellectual inputs. CP was directly involved in patient care and edited the draft and intellectual inputs. RA conceptualized the project, assisted in data analysis, manuscript reviewing and editing, statistical inputs, and critical thinking.