Drug-eluting contact lens now available for relieving itch of allergic conjunctivitis

Johnson & Johnson Vision Care is introducing Acuvue Theravision with Ketotifen Contact Lenses (etafilcon A daily disposable contact lens containing ketotifen 0.019 mg per lens). The daily-wear disposable soft contact lenses are indicated for correcting refractive ametropia (myopia and hyperopia) in phakic or aphakic patients who are suitable for contact lens wear. They are intended for contact lens wearers who experience ocular itch due to allergic conjunctivitis and who do not have red eye(s) or more than 1.00 D of astigmatism. Safety and efficacy of the lenses have been established only in patients 12 years of age or older.1 Mechanism of action: Etafilcon A is a widely used hydrogel contact lens material. The new contact lenses also contain ketotifen, an H1 histamine receptor antagonist with mast cell-stabilizing properties. Ketotifen is already available by prescription in Canada as a 0.025% ophthalmic solution (Zaditor) for the treatment of allergic conjunctivitis. Ketotifen prevents itch associated with allergic conjunctivitis experienced by contact lens users and promotes comfortable lens wear without the need for allergy eye drops. Itch prevention lasted for 12 hours in clinical trials.1-3 Read: Helping patients with rheumatoid arthritis transition from biologics to other drugs Dosage/administration: Patients should be instructed to insert one contact lens per eye per day. If the lenses are removed during the day, patients should be warned not to insert new ketotifen-containing lenses; instead, nonmedicated lenses may be worn for the remainder of the day. However, ketotifen-containing lenses may be worn beyond 12 hours for vision correction. If prevention or relief from itching is needed beyond 12 hours, the lenses should be removed and advice sought from an eye care professional.1 Ketotifen-containing lenses should be removed before sleep and discarded after a single day’s use.1 Read: New Canadian guidelines for managing labour and delivery in persons with a physical disability Adverse effects: The most common ocular adverse reactions (< 2% incidence) are eye irritation, eye pain, instillation site irritation, dry eye, photophobia and mydriasis. The most frequent nonocular adverse reactions (≤ 3% incidence) are nasopharyngitis and sinusitis.1 Acuvue Theravision with Ketotifen Contact Lenses should not be used to treat red eyes. Patients should be advised to remove the lenses immediately if their eyes become red or irritated. Contact lenses carry the risk of developing corneal ulcers, particularly in smokers or if the lenses are worn overnight.1 Drug interactions: Eye drops containing benzalkonium chloride should not be used simultaneously with these contact lenses. Advise patients to wait 10 minutes after eye drop instillation before inserting lenses.1 Efficacy of Acuvue Theravision with Ketotifen Contact Lenses has been examined in two clinical trials. These trials involved patients ≥ 12 years of age with ocular allergies who regularly wore contact lenses for vision correction. The ketotifen-eluting lenses were significantly more effective than similar drug-free (control) lenses in preventing ocular itch at 15 minutes and 12 hours after insertion. Although the drug-eluting lenses were also more effective than the control lenses in reducing redness, the difference did not reach the pre-established threshold for clinical significance. The long-term efficacy and safety of using contact lenses to deliver medications remains to be established.3 Read: New guidelines for managing cutaneous lupus erythematosus Place in therapy: Acuvue Theravision with Ketotifen Contact Lenses may be more convenient than using antihistamine eye drops to treat allergic conjunctivitis in contact lens wearers. Antihistamine eye drops usually contain a preservative and require removal of contact lenses before administration.3 Comments: Acuvue Theravision with Ketotifen Contact Lenses are the first drug-eluting contact lenses to be approved in Canada. They are classified as medical devices in Canada and are available by prescription-only through ophthalmologists or optometrists.4 References 1. Johnson & Johnson Vision Care, division of Johnson & Johnson, Inc. Acuvue Theravision with Ketotifen Contact Lenses (etafilcon A with ketotifen daily disposable contact lens) prescribing information. January 2021. (accessed April 13, 2022). 2. Johnson & Johnson Vision. Johnson & Johnson Vision receives approval in Canada for world's first and only drug-releasing contact lens for vision correction and allergic eye itch: Acuvue Theravision with Ketotifen. April 27, 2021. (accessed April 13, 2022). 3. Anon. A drug-eluting contact lens for allergic conjunctivitis. Med Lett Drugs Ther 2022;63:60-1. 4. Lachmansingh T. Acuvue Theravision with Ketotifen 2022 launch announcement letter. (accessed April 13, 2022).

Drug-eluting contact lens now available for relieving itch of allergic conjunctivitis

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