International, Ophthalmology, Research

Treatment for CSCR found to have “no benefit”

New research from the University of Bristol and University Hospital Southampton has concluded that eplerenone offers no benefit for patients suffering from central serous chorioretinopathy (CSCR), and subsequently should no longer be prescribed for the condition.

Eplerenone, a drug that decreases the activity of hormones that regulate salt and water in the body, was previously noted to improve the vision of those suffering from CSCR, albeit with only limited clinical data. The drug is also associated with side effects including increased potassium levels, altered heart rhythms and a decrease in blood pressure.

The limited clinical data and negative side effects prompted a study into the long-term effectiveness of the drug, which was funded by the UK’s Medical Research Council and National Institute for Health Research Efficacy and Mechanism Evaluation.

As part of the study 111 patients across 22 sites for 12 months received either eplerenone or a placebo. According to the study, which has now been published in the highly respected medical journal The Lancet, eplerenone offers no benefit to treating patients and its use should cease.

“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,” Professor Andrew Lotery, professor of ophthalmology at the University of Southampton and consultant ophthalmologist at University Hospital Southampton, said.

“However, as these drugs can have side effects such as hyperkalaemia, which causes a rise in potassium and can affect heart rhythm, it was important to the [National Health Service] 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.”

Instead, Lotery advocated for ophthalmologists to cease using the medication and instead look to participate in future trials for alternative treatments.

The study was managed by researchers from the Bristol Trials centre at Bristol Medical School and the University of Bristol.

“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,” Professor Barnaby Reeves, professional research fellow in health services research at the Bristol Trials Centre, said.

“Researchers can now focus their attention on alternative interventions.”

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