Clinical experience with the long-term use of 1% apraclonidine. Incidence of allergic reactions
P. Butler, M. Mannschreck, S. Lin, I. Hwang and J. Alvarado
Department of Ophthalmology, University of California, San Francisco.
OBJECTIVE: To identify the incidence and characteristics of allergic
reactions associated with the long-term use of 1% apraclonidine
hydrochloride. METHODS: We undertook a retrospective analysis of 64
patients receiving long-term 1% apraclonidine therapy at the University of
California-San Francisco Glaucoma Service. Patients were excluded if the
duration of treatment was less than 2 weeks. Demographic data, initial
intraocular pressure response, and incidence and characteristics of
allergic reactions were obtained through chart review. Student's t test and
chi 2 analysis were used to analyze the demographic data, and Kaplan-Meier
survival analysis was used to estimate the long-term incidence of local
reactions. RESULTS: Sixty-four patients met the criteria for the study. Of
these, 31 (48%) developed an allergic reaction (responders) that led to
discontinuation of treatment with the medication, with a mean latency of
4.7 months. Mean follow-up was 13.3 months. Patients free of local
reactions (nonresponders) for at least 10 months were able to successfully
continue apraclonidine use. Responders tended to be older and female.
CONCLUSIONS: Our data are specific for the 1% preparation; however,
physicians prescribing apraclonidine on a long-term basis should be aware
of possible allergic reactions. A substantial percentage of patients
developed this side effect, but most tolerated the medication for up to 4
months, and those without a local reaction after 10 months appeared to be
able to continue apraclonidine use indefinitely. This allergic reaction is
likely related to the adrenergic agent itself, and not to preservatives.
