A comparative study of efficacy and safety of alcaftadine 0.25% versus olopatadine hydrochloride 0.2% in allergic conjunctivitis at a tertiary care hospital

Background: Ocular itching is the hallmark symptom of allergic conjunctivitis, accompanied by tearing, conjunctival redness, eyelid swelling, and chemosis. Alcaftadine and olopatadine hydrochloride are classified as dual-acting antiallergic agents, used in the treatment of allergic conjunctivitis. Objective: The aim is to compare the efficacy and safety of alcaftadine 0.25% and olopatadine hydrochloride 0.2% eye drops among patients with allergic conjunctivitis. Settings and Design: Ophthalmology outpatient department at Minto Ophthalmic Hospital, Bangalore Medical College and Research Institute, Bengaluru; prospective, randomized, comparative study. Subjects and Methods: This study was conducted among 120 patients suffering from grade 3 Allergic conjunctivitis and efficacy measured in terms of proportion of patients achieving symptomatic relief of allergic ocular signs and symptoms from grade 3 to grade 0 from baseline to 2 weeks, using Total Ocular Symptoms Score (TOSS) and Conjunctival Hyperemia scale. Safety assessed by monitoring treatment-emergent adverse effects. Continuous data assessed by unpaired, paired t-test and repeated measures-ANOVA and categorical data by Chi-square test. P <0.05 was considered statistically significant, whereas < 0.001 as highly significant. Results: Greater proportion of patients achieved symptomatic relief in the Alcaftadine group (98.3%) compared to the olopatadine hydrochloride group (90%) at end of 2 weeks. A significant and faster reduction in TOSS score was observed from baseline to 2 weeks in alcaftadine treated group compared to the olopatadine hydrochloride group (P < 0.05). Adverse events reported were headache, burning sensation, and mild redness in both groups. Conclusion: Alcaftadine 0.25% demonstrated greater efficacy in reducing ocular signs and symptoms of allergic conjunctivitis from baseline to 2 weeks, compared to olopatadine hydrochloride 0.2% with minimal side-effects.