Preoperative tranilast as adjunctive therapy to primary pterygium surgery with a 1-year follow-up

Arq Bras Oftalmol. 2015 Jan-Feb;78(1):1-5. doi: 10.5935/0004-2749.20150002.

Abstract

Purpose: To determine the efficacy of tranilast as an adjunctive therapy in conjunctival autograft.

Methods: Twenty-nine patients were randomly allocated to the Tranilast Group (n=15) or the Control Group (n=14). The Tranilast Group received a subconjunctival injection of 0.5% tranilast 30 days prior to surgery. Conjunctival autograft was performed in both groups using fibrin sealant and 0.02% subconjunctival mitomycin C at the end of the surgery. After the resection of the pterygium, immunohistochemistry was performed with 100 cells to identify epithelial cells positive for transforming growth factor-β (TGF-β). Subjective symptoms were evaluated using a 5-point scale, and the recurrence rate was assessed.

Results: Both groups showed improvements in their symptoms and similar clinical results. Compared with the Control Group, the Tranilast Group failed to show a decreased recurrence rate (p=0.59). However, the number of epithelial cells expressing TGF-β was lower in the Tranilast Group (5 cells; 95% CI: 2.56-13.15; Control Group, 16 cells, 95% CI: 11.53-24.76; p=0.01). Minimal but reversible complications, including glaucoma secondary to corticosteroids and granuloma, occurred during the study.

Conclusion: Tranilast was effective in decreasing the number of pterygium epithelial cells expressing TGF-β.

Trial registration: ClinicalTrials.gov NCT01003613.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Autografts
  • Conjunctiva / drug effects
  • Conjunctiva / metabolism
  • Conjunctiva / transplantation*
  • Epithelial Cells / drug effects*
  • Epithelial Cells / metabolism
  • Female
  • Fibrin Tissue Adhesive / therapeutic use
  • Follow-Up Studies
  • Humans
  • Injections, Intraocular
  • Male
  • Middle Aged
  • Mitomycin / therapeutic use
  • Postoperative Period
  • Preoperative Care
  • Prospective Studies
  • Pterygium / drug therapy*
  • Pterygium / metabolism
  • Pterygium / prevention & control
  • Pterygium / surgery*
  • Recurrence
  • Secondary Prevention / methods
  • Transforming Growth Factor beta / metabolism*
  • Transplantation, Autologous
  • Treatment Outcome
  • ortho-Aminobenzoates / administration & dosage*

Substances

  • Fibrin Tissue Adhesive
  • Transforming Growth Factor beta
  • ortho-Aminobenzoates
  • Mitomycin
  • tranilast

Associated data

  • ClinicalTrials.gov/NCT01003613