Eyeworld

81 EW FEATURE September 2015 World Cornea Congress highlights patients or to individuals allergic to components of the vaccine." Dr. Chan disagreed, as "the safety and efficacy for preventing recurrences in patients who have a history of HZO is unknown. If a patient has had a zoster recurrence, to me that is already indicative of an immune boost similar to that induced by the vaccine, thus the vaccine is unlikely to offer any additional protection in a patient with recurrent HZO." She also would not recommend the vaccine to a patient who has a history of ocular complications related to HZO. "The vaccine increases the body's cellular mediated immunity against vari- cella zoster virus (VZV), which can target any persistent herpes zoster DNA in ocular tissues resulting in a T-lymphocyte mediated recurrence of ocular manifestations in patients with a history of HZO," she said. VZV can trigger inflammation of giant cell arteritis; the latter is a VZV vasculopathy of the temporal artery, Dr. Cohen said, and antiviral treatment may be beneficial in these instances, and requires study. Dr. Cohen's group is submitting an application to the National Eye Institute to conduct a multicenter, placebo, randomized, controlled clinical study "to determine whether prolonged, suppressive valacyclovir treatment reduces complications of HZO, including chronic ocu- lar disease and PHN," she said. If approved, more than 1,050 patients with HZO in more than 60 U.S. cen- ters will be enrolled. "If patients are interested in healthy aging, they want to avoid this disease," she said. "It's often just the beginning of the end for older people." EW Editors' note: The physicians have no financial interests related to this article. Contact information Chan: clarachanmd@gmail.com Cohen: Elisabeth.cohen@nyumc.org Lee: bryan@bryanlee.pro Pepose: jpepose@peposevision.com Drug Interactions—Consider the following when prescribing SIMBRINZA ® Suspension: Concomitant administration with oral carbonic anhydrase inhibitors is not recommended due to the potential additive effect. Use with high-dose salicylate may result in acid-base and electrolyte alterations. Use with CNS depressants may result in an additive or potentiating effect. Use with antihypertensives/cardiac glycosides may result in additive or potentiating effect on lowering blood pressure. Use with tricyclic antidepressants may blunt the hypotensive effect of systemic clonidine and it is unknown if use with this class of drugs interferes with IOP lowering. Use with monoamine oxidase inhibitors may result in increased hypotension. For additional information about SIMBRINZA ® Suspension, please see Brief Summary of full Prescribing Information on adjacent page. Adverse Reactions SIMBRINZA ® Suspension In two clinical trials of 3 months' duration with SIMBRINZA ® Suspension, the most frequent reactions associated with its use occurring in approximately 3-5% of patients in descending order of incidence included: blurred vision, eye irritation, dysgeusia (bad taste), dry mouth, and eye allergy. Adverse reaction rates with SIMBRINZA ® Suspension were comparable to those of the individual components. Treatment discontinuation, mainly due to adverse reactions, was reported in 11% of SIMBRINZA ® Suspension patients. © 2015 Novartis 3/15 SMB15018JAD SIMBRINZA ® Suspension — Signifi cant IOP Reductions at All Studied Time Points When Added to a PGA 1 * Prescribe SIMBRINZA ® Suspension as adjunctive therapy to a PGA for appropriate patients SIMBRINZA ® Suspension should be taken at least fi ve (5) minutes apart from other topical ophthalmic drugs. * PGA study-group treatment consisted of either travoprost, latanoprost, or bimatoprost. † Treatment difference (mm Hg) and P-value at Week 6 was -3.7, P<0.0001. Reference: 1. Data on fi le, 2014. Study Design: A prospective, randomized, multicenter, double-blind, parallel-group study of 189 patients with open-angle glaucoma and/or ocular hypertension receiving treatment with a PGA. PGA treatment consisted of either travoprost, latanoprost, or bimatoprost. Patients in the study were randomized to adjunctive treatment with SIMBRINZA ® Suspension (N=88) or vehicle (N=94). The primary effi cacy endpoint was mean diurnal IOP (IOP averaged over all daily time points) at Week 6 between treatment groups. Key secondary endpoints included IOP at Week 6 for each daily time point (8 AM, 10 AM, 3 PM, and 5 PM) and mean diurnal IOP change from baseline to Week 6 between treatment groups. 1 IOP Time Points (mm Hg) 1‡ Treatment Arm 8 AM 10 AM 3 PM 5 PM PGA + SIMBRINZA ® Suspension (N=83) Baseline § 24.5 22.9 21.7 21.6 Week 6 19.4 15.8 17.2 15.6 PGA + Vehicle (N=92) Baseline § 24.3 22.6 21.3 21.2 Week 6 21.5 20.3 20.0 20.1 ‡ Least squares means at each Week 6 time point. Treatment differences (mm Hg) and P-values at Week 6 time points between treatment groups were: -2.14, P=0.0002; -4.56, P<0.0001; -2.84, P<0.0001; -4.42, P<0.0001. § Baseline (PGA Monotherapy). Mean Diurnal IOP (mm Hg) 1|| Treatment Arm PGA + SIMBRINZA ® Suspension (N=83) Baseline ¶ 22.7 Week 6 17.1 PGA + Vehicle (N=92) Baseline ¶ 22.4 Week 6 20.5 ll Treatment difference (mm Hg) and P-value at Week 6 was -3.4, P<0.0001. ¶ Baseline (PGA Monotherapy). Learn more at myalcon.com/simbrinza Up to 7.1 mm Hg additional IOP reduction from baseline when added to a PGA 1 5.6 † mm Hg additional mean diurnal IOP lowering observed from baseline when added to a PGA 1 EYEWORLD 09.01.15 90714 " If patients are interested in healthy aging, they want to avoid this disease. It's often just the beginning of the end for older people. " –Elisabeth J. Cohen, MD

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