Rimexolone - A review of its pharmacological properties and clinical potential in the management of ocular inflammation

Rimexolone is a topically active nonfluorinated glucocorticoid which is available as a 1% ophthalmic suspension for the management of ocular inflammation. Its local anti-inflammatory activity is similar to that of dexamethasone and prednisolone. but it has a lower propensity than these drugs to increase intraocular pressure in susceptible individuals. Rimexolone is absorbed systemically after ocular instillation, but plasma concentrations are low and it is extensively metabolised to metabolites that are either inactive or have less activity than the parent drug. In a limited number of published clinical trials, rimexolone 1% ophthalmic suspension has shown efficacy similar to that of prednisolone acetate 1% in patients with anterior uveitis. Rimexolone was superior to placebo and comparable to dexamethasone and prednisolone acetate in controlling intraocular inflammation which developed after cataract surgery and more effective than placebo in alleviating symptoms of seasonal allergic conjunctivitis. Topical rimexolone 1% is generally well tolerated, with most adverse events being localised, transient, and of mild to moderate severity. Rimexolone was associated with a lower mean intraocular pressure than prednisolone acetate 1% during 4 weeks' treatment of patients with anterior uveitis. On the basis of available data, rimexolone 1% ophthalmic suspension appears to be an effective treatment for anterior uveitis, intraocular inflammation secondary to cataract surgery and moderately severe seasonal allergic conjunctivitis with a lesser tendency than prednisolone to cause ocular hypertension. Further comparisons with established treatments are required to more clearly establish its role in the management of ocular inflammation.