Usman Attique, Muhammad Tariq Khan, Irfan Aslam, Ahmed Usman Khalid


Background: Allergic conjunctivitis is a common hypersensitivity disorder that is prevalent globally. The objective of this trial was to compare the efficacy of Olopatadine versus Ketotifen ophthalmic solution in relieving itching in allergic conjunctivitis in population of Peshawar, Pakistan.

Materials & Methods: This RCT was conducted at Department of Ophthalmology, Khyber Girls Medical College, Peshawar, Pakistan from March 01, 2022 to June 30, 2022. One-eighty-six patients with allergic conjunctivitis with itching score of 2-3 and aged 5-65 years were randomly allocated to two groups; 93 to experimental/Olopatadine and 93 to control/Ketotifen group. Itching was graded as; no itching zero, mild itching 1, moderate itching 2 and severe itching 3. Pre-treatment itching score was measured. Experimental group used Olopatadine Hydrochloride 0.1% b.i.d., while control group used Ketotifen Fumarate 0.025% q.id., both for six-weeks. Post-treatment presence of itching was measured as 0-1 as itching relieved and 2-3 as not relieved. Sex, age groups, pre-treatment itching score and presence of itching were described by count and percentage. Hypothesis was verified using McNemar chi-square test.

Results: Experimental/Olopatadine group included 58 (62.37%) men and 35 (37.63%) women, while control/Ketotifen group included 55 (59.14%) men and 38 (40.86%) women. There were 78 (83.87%) patients in age group 5-35 years and 15 (16.13%) in age group 36-65 years in each group. Pre-treatment itching score was 2 in 40 (43.02%) and 3 in 53 (56.98%) patients in experimental group, and 2 in 42 (45.16%) and 3 in 51 (54.84%) patients in control group. Itching was relieved in 77 (82.80%) in experimental/Olopatadine group, and in 67 (72.04%) patients in control/Ketotifen group. Experimental/Olopatadine showed statistically significantly higher efficacy than control/Ketotifen (p-value .0139).

Conclusion: The efficacy of Olopatadine Hydrochloride 0.1% b.i.d. was higher than Ketotifen Fumerate 0.025% ophthalmic solution q.i.d. in terms of itching relief in allergic conjunctivitis.


Olopatadine Hydrochloride; Ketotifen Fumarate; Allergic Conjunctivitis.

Full Text:



Butrus S, Portela R. Ocular Allergy: Diagnosis and Treatment. Ophthalmol Clin N Am. 2005;18:485-92.

McCabe F, McCabe E. Comparative efficacy of bepotastine besilate 1.5% ophthalmic solution versus olopatadine hydrochloride 0.2% ophthalmic solution evaluated by patient preference. Clin Ophthalmol 2012;6:1731-8. https://doi.org/10.2147/OPTH.S35431

Kanski JJ, Bowling B. Conjunctiva. In: Gabbedy R, Cook L, editors. Clinical Ophthalmology. 7th ed. UK. Elsevier Saunders;2011:144-50. https://doi.org/10.1016/B978-0-7020-4093-1.00005-7

Ono S, Abelson M. Allergic conjunctivitis: update on pathophysiology and prospects for future treatment. Allergy Clin Immunol 2005;115(1);118-22. https://doi.org/10.1016/j.jaci.2004.10.042

Whitcup S. Recent advances in ocular therapeutics. Int Ophthalmol Clin 2006;46(4):1-6. https://doi.org/10.1097/01.iio.0000212140.70051.33

Allergic conjunctivitis [Internet] 2010 [updated 2013, cited 2022 June 22]. Available from: http://en.wikipedia.org/wiki/Allergic_conjunctivitis

Galor A, Small L, Feuer W, Levitt RC, Sarantopoulos KD, Yosipovitch G. Relationship between ocular itch, ocular pain, and dry eye symptoms. Trans Am Ophthalmol Soc 2018;17:115.

Zar JH. Biostatistical Analysis. 5th ed. Englewood Clifts, New Jersey: Prentice-Hall, Inc. p.127.

Pegano M, Gauvreau K. Principals of Biostatistics. 2nd ed. Boston, MA, USA: Cengage Learning 2000:349-52.

Motulsky HJ. GraphPad, QuickCalcs. McNemar's test to analyze experimental studies [accessed 2022 June 22]. GraphPad Software, San Diego, CA, USA. Available at: https://www.graphpad.com/ quickcalcs/McNemar1.cfm

Sarker SJ, Chowdhury AN, Hussain Z, Hossain AM, Chowdhury H. Comparison of the therapeutic efficacy of 0.1% olopatadine hydrochloride and 0.025% ketotifen fumarate in allergic conjunctivitis. Clin Practice 2011;8(5):545. https://doi.org/10.2217/thy.11.48

Patel D, Sarala N, Datti NP. Topical olopatadine hydrochloride versus ketotifen fumarate for allergic conjunctivitis. J Ophthalmic Vis Res 2018 Apr-Jun;13(2):119-23. https://doi.org/10.4103/jovr.jovr_85_17

Varguez-Rodríguez ME, Hernández-López A, Gómez-Dávila Rde L. Comparison of olopatadin and ketotifen in the treatment of allergic conjunctivitis [Spanish]. Rev Med Inst Mex Seguro Soc 2009;47(4):399-404.

Mortemousque B, Bourcier T, Khairallah M, Messaoud R, Brignole-Baudouin F, Renault D, et al. Ketotifen Study Group. Comparison of preservative-free ketotifen fumarate and preserved olopatadine hydrochloride eye drops in the treatment of moderate to severe seasonal allergic conjunctivitis. J Fr Ophtalmol 2014;37(1):1-8. https://doi.org/10.1016/j.jfo.2013.02.007

Ganz M, Koll E, Gausche J, Detjen P, Orfan N. Ketotifen fumarate and olopatadine hydrochloride in the treatment of allergic conjunctivitis: a real-world comparison of efficacy and ocular comfort. Adv Ther 2003;20(2):79-91. https://doi.org/10.1007/BF02850255

Avunduk AM, Tekelioglu Y, Turk A, Akyol N. Comparison of effects of ketotifen fumarate 0.025% and olopatadine HCI 0.1% ophthalmic solutions in seasonal allergic conjunctivitis: a 30-day, randomized, double-masked, artificial tear substitute-controlled trial. Clin Ther 2005;27(9):1392-402. https://doi.org/10.1016/j.clinthera.2005.09.013

Berdy GJ, Stoppel JO & Ebstein AB : Comparison of the clinical efficacy and tolerability of olopatadine hydrochloride 0.1% ophthalmic solution and loteprednol etabonate 0.2% ophthalmic suspension in th.e conjunctival allergen challenge model. Clin Ther 2002;(24):918-29. https://doi.org/10.1016/S0149-2918(02)80007-8

Kamis U, Ozturk BT, Ozkagnici A, Gunduz K. Comparison of the efficacy of olopatadine hydrochloride 0.1% ophthalmic solution and artificial tears in seasonal allergic conjunctivitis. Acta Ophthalmol Scand 2006(84):148-9. https://doi.org/10.1111/j.1600-0420.2006.00620.x

Aguilar AJ. Comparative study of clinical efficacy and tolerance in seasonal allergic conjunctivitis management with 0.1% olopatadine hydrochloride versus 0.05% ketotifen fumarate. Acta Ophthalmol Scand 2000;78:52-5. https://doi.org/10.1034/j.1600-0420.2000.078s230052.x

Leonardi A, Zafirakis P. Efficacy and comfort of olopatadine versus ketotifen ophthalmic solutions: a double-masked, environmental study of patient preference. Curr Med Res Opin 2004;20:1167-73. https://doi.org/10.1185/030079904125004321

Lainer B, Finegold I, D'Arienzo P, Granet D, Ebstein AB, Ledgerwood GL. Clinical efficacy of olopatadine versus epinastine ophthalmic solution in the conjunctival allergen challenge model. Curr Med Res Opin 2004;20:1227-33. https://doi.org/10.1185/030079904125004330

Abelson MB, Spangler DL, Epstein AB, Mah FS, Crampton HJ. Efficacy of once-daily olopatadine 0.2% ophthalmic solution compared to twice-daily olopatadine 0.1% ophthalmic solution for the treatment of ocular itching induced by conjunctival allergen challenge. Curr Eye Res 2007;32(12):1017-22. https://doi.org/10.1080/02713680701736558

Guest JF, Clegg JP, Smith AF. Health economic impact of olopatadine compared to branded and generic sodium cromoglycate in the treatment of seasonal allergic conjunctivitis in the UK. Curr Med Res Opin 2006;22(9):1777-85. https://doi.org/10.1185/030079906X115739

Alam A, Rehman AU, Waheed D, Khan MH, Ahmad W, Bashir I, et al. Post-operative oral antibiotics in reducing frequency of surgical site infection following non-perforated appendectomy in population of South Waziristan Agency, Pakistan. Gomal J Med Sci 2021;19(2):53-7. https://doi.org/10.46903/gjms/19.02.936

Khan A, Hussain A, Wahab M, Rehman A, Latif SA, Naqvi SWA, et al. Distribution of drug sensitive tuberculosis by sex, age groups and type of disease in DS-TB population of District D.I.Khan, Pakistan. Gmal J Med Sci 2021;19(2):66-72. https://doi.org/10.46903/gjms/19.02.1012

DOI: https://doi.org/10.46903/20.04.1267


  • There are currently no refbacks.

Copyright (c) 2022 Usman Attique, Muhammad Tariq Khan, Irfan Aslam, Ahmed Usman.

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Gomal Medical College, Daraban Road, Dera Ismail Khan, Pakistan

ISSN: 1819-7973, e-ISSN: 1997-2067

Website: https://www.gmcdikhan.edu.pk

Phone: +92-966-747373

Scimago Journal & Country Rank