Flurbiprofen (Froben) is one of the nonselective cyclooxygenase (COX) inhibitors blocking both COX-1 and COX-2 pathways. Agrawal et al. undertook a retrospective cohort study to determine the effectiveness of oral Froben in managing noninfectious, non-necrotising anterior scleritis. One hundred and twenty-six patients were allocated to either group A (oral Froben only, n=65) or group B (oral Froben with topical steroids, n=61). Diffuse non-necrotising scleritis was the most common pathology encountered in both groups. Froben was stopped after disease remission in 62 patients in group A and 54 in group B. Patients in either group were on treatment for an average of 74 days. Three from group A and seven from group B required corticosteroid therapy or immunosuppressive therapy due to nonresponse or recurrent episodes of scleritis. Scatter plot for pre- and post-treatment visual acuity showed a linear correlation among all 126 patients. On follow-up, flurbiprofen was not found to be effective in anterior diffuse non-necrotising scleritis with associated systemic disease. The major side-effects noted in Groups A and B were gastrointestinal intolerance. Although not statistically significant, patients on combination therapy of oral flurbiprofen and topical steroids might have slightly prolonged time to failure against those on oral flurbiprofen only. Non-steroidal agents can be quite effectively used in selected cases of diffuse non-necrotising scleritis, hence obviating the need for corticosteroids or immunosuppressives. Failure to respond should alert one to the possibility of an underlying disease, since these patients are less likely to respond.
Froben for anterior scleritis
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