The Efficacy and Safety of Dexamethasone Intracanalicular Insert Use in Patients with Chronic Seasonal/Perennial Allergic Conjunctivitis: A Systematic Review and Meta-Analysis

Ali S Alsudais,1,2 Waleed Mohammed Alshehri,3 Ahmed M Alrehaili,4 Reyadh Khalid Albeladi,5 Mohammed Khoshhal,4,6 Ahmed Albelowi,4 Raghad Saleh Alzahrani,1,2 Ahmed Alnabihi,1,2 Bader Bashrahil,1,2 Omar Alabbasi3 1College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia; 2King Abdullah International Medical Research Center, Jeddah, Saudi Arabia; 3Department of Ophthalmology, King Salman Bin Abdulaziz Medical City, Madinah, Saudi Arabia; 4College of Medicine, Taibah University, Madinah, Saudi Arabia; 5College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; 6Ohud Hospital, Madinah, Saudi ArabiaCorrespondence: Ahmed Alnabihi, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, 21423, Saudi Arabia, Tel +966569493360, Email [email protected]: This meta-analysis evaluated the efficacy and safety of DEXTENZA, an intracanalicular dexamethasone insert, for the treatment of seasonal/perennial allergic conjunctivitis.Methods: Multiple databases, including PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL), ClinicalTrials.gov, the Directory of Open Access Journals, and Scopus, were searched for randomized controlled trials (RCTs) comparing the efficacy of DEXTENZA with a placebo. The primary efficacy endpoint was the change in the conjunctival allergen challenge (CAC) model. The GRADE approach was used to assess the certainty of evidence, and the revised Cochrane risk of bias tool for randomized trials was employed to assess bias.Results: Four RCTs involving 323 participants met the eligibility criteria, and all had a low risk of bias. A meta-analysis revealed a statistically significant increase in the mean CAC change for conjunctival itching, with low heterogeneity among measurements at 3 minutes (P