Topical 5-fluorouracil, interferon alfa-2b eye drops both effective, safe for OSSN
Topical 5-fluorouracil 1% (5FU) is as good as interferon alfa-2b 1 MIU/mL (IFN) eye drops in the primary treatment of ocular surface squamous neoplasia (OSSN), with both modalities leading to high tumour resolution and low recurrence rates, a recent study has shown.
Researchers examined the medical records of 54 patients who received 5FU and 48 patients who received IFN as primary therapy for OSSN. Primary outcome measures included the frequency of clinical resolution and time to OSSN recurrence. Secondary outcome was the frequency of side effects with each therapy.
The mean age of the cohort was 68 years, and a greater proportion of Hispanics were treated with 5FU. In a univariable analysis, the frequency of OSSN resolution was higher with 5FU than with IFN (96.3 percent vs 81.3 percent; p=0.01). However, multivariable analysis showed that treatment modality was not a significant predictor of resolution.
Among patients with resolved OSSN, mean time to resolution was similar between 5FU and IFN (mean 6.6 vs 5.5 months; p=0.17). Likewise, there was no significant difference in the number of resolved lesions that recurred (6 of 52 eyes vs 2 of 39 eyes, respectively; p=0.46), with Kaplan Meier survival curves of OSSN recurrence being similar between the two teatment groups (log rank=0.16).
Recurrence rates at 1 year were 11.4 percent with 5FU and 4.5 percent with IFN. Adverse events such as eyelid oedema (p=0.04) and tearing (p=0.02) were more significant with 5FU.
The present data suggest that both topical 5FU and IFN eye drops are effective treatment options for OSSN.