Comparative evaluation of efficacy and safety of bepotastine besilate 1.5% ophthalmic solution versus olopatadine hydrochloride 0.1% ophthalmic solution in patients with vernal keratoconjunctivitis

Background: Vernal keratoconjunctivitis (VKC) is a chronic, seasonally exacerbated, allergic ocular inflammation. It affect children and young adults and has male predominance. The first line of treatment often used is dual acting drugs like olopatadine and bepotastine. It combine the immediate histamine receptor antagonism, coupled with mast cell stabilization with other anti-inflammatory properties. The present study was conducted to compare the efficacy and safety of olopatadine 0.1% and bepotastine 1.5% eye drops in VKC patients.Methods: This was a prospective, open label, randomized and comparative clinical study conducted for 21 days. 65 patients of VKC of 5-15 years of either sex were randomized in two study arm. Arm A, given bepotastine 1.5% and arm B, given olopatadine 0.1% twice daily for 21 days. Symptoms and signs scoring of VKC along with safety assessment were recorded on baseline and at time of follow up on 7th day and 21st day.Results: After 3 weeks of drug therapy, patients in both arms showed improvement in the symptoms and signs scoring of VKC. There was no statistically significant difference between the two treatment arms. However, improvement in clinical parameters particularly ocular itching, which is the main complaint of patients with VKC was more in bepotastine arm as compared to olopatadine treated arm. Both the drugs were well tolerated without any serious adverse effect.Conclusions: Both olopatadine and bepotastine were found to be effective in alleviating the clinical symptoms and signs of VKC. However, bepotastine performed better in reducing ocular itch than olopatadine.