A drug used widely to treat a common eye condition has no benefit, study

Evaluating whether eplerenone was superior to placebo in terms of improving visual acuity in patients with chronic CSCR.

In chronic central serous chorioretinopathy (CSCR), fluid accumulates in the subretinal space. CSCR is a common, visually disabling condition that develops in individuals up to 60 years of age, and there is no definitive treatment.

Past study has suggested that the mineralocorticoid receptor antagonist, eplerenone, is effective for treating CSCR.

However, this drug is not licensed for the treatment of patients with CSCR. Thus, a new study by the scientists from the University of Bristol and University Hospital Southampton aimed to determine whether eplerenone is superior to treat CSCR.

Scientists found that Eplerenone has no benefit and should no longer be used. There was no benefit of treating patients with eplerenone compared to those who took a placebo.

Prof Lotery, a professor of ophthalmology at the University of Southampton, said“Despite a lack of robust clinical trial evidence, eplerenone and other similar drugs are widely used by ophthalmologists as first-line therapy for the treatment of CSCR.”

“However, as these drugs can have side effects such as hyperkalemia, which causes a rise in potassium and can affect heart rhythm, it was important to the NHS that we determine efficacy and safety.”

“After a year of follow-up, this study found no benefit of treating patients with eplerenone compared to those patients that took a placebo tablet.”

“This is an important practice-changing finding and should prompt ophthalmologists to stop treating CSCR with eplerenone, instead opting to participate in future trials of other potential interventions.”

Professor Barnaby Reeves, of the Bristol Trials Centre, said: “It has been rewarding to collaborate on a study that has generated such a clear answer – all aspects of participants’ vision that we measured showed no benefit of eplerenone. Researchers can now focus their attention on alternative interventions.”

The study was co-led by Professor Sobha Sivaprasad, a consultant ophthalmologist at Moorfields Eye Hospital, and managed by researchers from the Bristol Trials Centre at Bristol Medical School at the University of Bristol which co-designed the study and analyzed the data. Twenty-two hospitals participated and recruited participants for the study.

The results of the study are published today by The Lancet.

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