Valentin Navel1, Aurélien Mulliez2, Cédric Benoist d'Azy3, Julien S Baker4, Jean Malecaze3, Frédéric Chiambaretta3, Frédéric Dutheil5. 1. University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Ophthalmology, F-63000, Clermont-Ferrand, France. Electronic address: vnavel@chu-clermontferrand.fr. 2. University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Biostatistics Unit, Clinical Research and Innovation Direction, F-63000, Clermont-Ferrand, France. 3. University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Ophthalmology, F-63000, Clermont-Ferrand, France. 4. University of the West of Scotland, Institute for Clinical Exercise and Health Science, Hamilton, United Kingdom. 5. University Hospital of Clermont-Ferrand, CNRS, LaPSCo, Physiological and Psychosocial Stress, CHU Clermont-Ferrand, Preventive and Occupational Medicine, Witty Fit, F-63000, Clermont-Ferrand, France; Australian Catholic University, Faculty of Health, School of Exercise Science, Melbourne, Victoria, 3065, Australia.
Abstract
PURPOSE: We conducted a systematic review and meta-analysis to evaluate the efficacy of different treatment for Demodex blepharitis. Parameters studied were mites count, improvement of symptoms and mites' eradication, stratified on type of treatments and mode of delivery of treatments (local or systemic). METHOD: The PubMed, Cochrane Library, Embase, ClinicalTrials.gov, Google scholar and Science Direct databases were searched for studies reporting an efficacy of treatments for Demodex blepharitis. RESULTS: We included 19 studies (14 observational and 5 randomized clinical trials), for a total of 934 patients, 1741 eyes, and 13 different treatments. For mites count, eradication rate, and symptoms improvement, meta-analysis included fifteen, fourteen and thirteen studies, respectively. The overall effect sizes for efficiency of all treatments, globally, were 1.68 (95CI 1.25 to 2.12), 0.45 (0.26-0.64), and 0.76 (0.59-0.90), respectively. Except usual lid hygiene for mites count, Children's Hospital of Eastern Ontario ointment (CHEO) for both eradication rate and symptoms, and CHEO, 2% metronidazole ointment, and systemic metronidazole for eradication rate, all treatments were efficient. Stratified meta-analysis did not show significant differences between local and systemic treatments (1.22, 0.83 to 1.60 vs 2.24, 1.30 to 3.18 for mites count; 0.37, 0.21 to 0.54 vs 0.56, 0.06 to 0.99 for eradication rate; and 0.77, 0.58 to 0.92 vs 0.67, 0.25 to 0.98 for symptoms improvement). CONCLUSION: We reported the efficiency of the different treatments of Demodex blepharitis. Because of less systemic side effects, local treatments seem promising molecules in the treatment of Demodex blepharitis.
PURPOSE: We conducted a systematic review and meta-analysis to evaluate the efficacy of different treatment for Demodex blepharitis. Parameters studied were mites count, improvement of symptoms and mites' eradication, stratified on type of treatments and mode of delivery of treatments (local or systemic). METHOD: The PubMed, Cochrane Library, Embase, ClinicalTrials.gov, Google scholar and Science Direct databases were searched for studies reporting an efficacy of treatments for Demodex blepharitis. RESULTS: We included 19 studies (14 observational and 5 randomized clinical trials), for a total of 934 patients, 1741 eyes, and 13 different treatments. For mites count, eradication rate, and symptoms improvement, meta-analysis included fifteen, fourteen and thirteen studies, respectively. The overall effect sizes for efficiency of all treatments, globally, were 1.68 (95CI 1.25 to 2.12), 0.45 (0.26-0.64), and 0.76 (0.59-0.90), respectively. Except usual lid hygiene for mites count, Children's Hospital of Eastern Ontario ointment (CHEO) for both eradication rate and symptoms, and CHEO, 2% metronidazole ointment, and systemic metronidazole for eradication rate, all treatments were efficient. Stratified meta-analysis did not show significant differences between local and systemic treatments (1.22, 0.83 to 1.60 vs 2.24, 1.30 to 3.18 for mites count; 0.37, 0.21 to 0.54 vs 0.56, 0.06 to 0.99 for eradication rate; and 0.77, 0.58 to 0.92 vs 0.67, 0.25 to 0.98 for symptoms improvement). CONCLUSION: We reported the efficiency of the different treatments of Demodex blepharitis. Because of less systemic side effects, local treatments seem promising molecules in the treatment of Demodex blepharitis.
Authors: Harrison Dermer; Daniella Lent-Schochet; Despoina Theotoka; Christian Paba; Abdullah A Cheema; Ryan S Kim; Anat Galor Journal: Drugs Date: 2020-04 Impact factor: 9.546