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Piiloset Trehalose Emulsion Eye Drop Study in Moderate or Severe Dry Eye

A Randomized, Active-controlled, Parallel, Double-blind Study on the Safety, Ocular Tolerability and Efficacy of Piiloset Trehalose Emulsion Eye Drop in Adult Patients With Moderate or Severe Dry Eye

Status
Completed
Phases
NA
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT03569202
Enrollment
64
Registered
2018-06-26
Start date
2018-05-21
Completion date
2018-11-08
Last updated
2019-12-13

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Dry Eye Syndrome

Keywords

Lubricant Eye Drops, Moderate or Severe Dry Eye, Hyaluronic Acid, Trehalose, Disaccharides, Polysaccharides, Fatty Acids, Omega-3, Tears, Osmolar Concentration, Anterior Eye Segment, Severity of Illness Index

Brief summary

The study evaluates the safety, ocular tolerability and efficacy of emulsion eye drops with sacha inchi seed oil, trehalose and hyaluronic acid in the treatment of moderate or severe dry eye in adult patients. The investigative device is studied in comparison with control eye drops containing hyaluronic acid for up to 30 days.

Detailed description

According to the current view on dry eye disease, tear film instability, tear film hyperosmolarity, and ocular surface inflammation and damage are identified as etiological factors. The first-line medicinal management options include ocular lubricants such as eye drops and sprays. Emulsion eye drops are a relatively recent entity among topical therapies with an intention to account for deficiencies in the outermost lipid layer of the tear film. Piiloset Trehalose Emulsion Eye Drops was developed to target and restore the three main layers (mucin, aqueous, and lipid) of the tear film and to counteract the key etiological factors leading to dry eye. Hyaluronic acid and the oil component are intended to restore tear film instability, the hypo-osmolar composition and trehalose as an osmoprotectant are intended to protect the ocular epithelium against hyperosmolarity, and ocular surface inflammation and cellular damage are prevented by the cytoprotective and/or anti-oxidative action of hyaluronic acid, trehalose, and sacha inchi oil components. Additional water binding in the tear film is provided by hyaluronic acid, trehalose, and glycerol. Lubricating the ocular surface by high-molecular-weight hyaluronic acid will extend the precorneal retention time. Adjustments made to certain physical and chemical parameters in the formulation are anticipated to improve tear film spreading and adhesion. The optically clear o/w emulsion formulation is free of preservatives, materials of animal origin, phosphates, or alcohol. The combined action of the individual components is expected to produce clinically relevant mitigation of the signs and symptoms of dry eye. The study comprises three Parts with scheduled visits on Day 1 (all Parts) and on end-of-study date (Parts 2 and 3) to the study centre. Each study subject will participate in no more than one Part of the study.

Interventions

DEVICEPiiloset Trehalose Emulsion Eye Drops

Topical application of preservative-free multidose Piiloset Trehalose Emulsion Eye Drops 3 times daily

Topical application of preservative-free multidose Hyaluronic Acid Eye Drops 3 times daily

Sponsors

Finnsusp Ltd.
CollaboratorINDUSTRY
4Pharma Ltd.
CollaboratorINDUSTRY
Business Finland
CollaboratorOTHER
Kuopio University Hospital
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)

Intervention model description

Part 1. Piiloset Trehalose Emulsion Eye Drop is administered on the worst eye four times during office hours of one day at the study centre. Part 2. Piiloset Trehalose Emulsion Eye Drop is self-administered on a randomized eye and the control eye drops on the contralateral eye three times a day for 10 days in a double-blinded fashion. Part 3. Either Piiloset Trehalose Emulsion Eye Drop or the control eye drops are self-administered on both eyes three times a day for 30 days in a randomized and double-blinded fashion.

Eligibility

Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No

Inclusion criteria

1. Ability and willingness to give informed written consent prior to any screening procedure after explanation of the nature and possible consequences of the study. 2. Age between 18 and 80 years. 3. At least two the following conditions (A and B): A. Symptomatic dry eye with OSDI score ≥20. AND B1. Tear film break-up time (TBUT) \<10 seconds. OR B2. Positive ocular (corneal and conjunctival) staining pattern 4. Body weight at least 45 kg. 5. Under stable topical and/or systemic therapy for at least 4 weeks before the study procedures and apparent ability and willingness to abstain from other therapies until completion of the study period. 6. Ability and willingness to self-administer eye drops. 7. Ability and willingness to understand and fill in the OSDI questionnaire. 8. Ability and willingness to comply with the study protocol and other study-related procedures.

Exclusion criteria

1. History of ocular surgery, trauma, or refractive laser vision correction procedure less than 3 months earlier. 2. Evidence of acute or chronic infection in the cornea or conjunctiva. 3. Diagnosis of Sjögren's syndrome. 4. Unwillingness or apparent disability to discontinue contact lens use during study period and at least one week before the first dosing day. 5. Current ocular allergy symptoms. 6. Known allergy to any constituent of the trehalose emulsion eye drops or control eye drops. 7. Currently pregnant, nursing or planning to become pregnant before completion of the study period. 8. Any other condition that may, in the Investigator's opinion, jeopardize the safety or availability of the subject or adherence to the study protocol or may interfere with the interpretation of the results and would thus make the subject inappropriate for entry in the study.

Design outcomes

Primary

MeasureTime frameDescription
Change From Baseline OSDIFrom baseline to Day 30 (Part 3)Ocular Surface Disease Index (OSDI) is a questionnaire consisting of 12 questions subdivided into 3 subscales for measuring the frequency of dry eye symptoms, vision-related quality of life and environmental triggers during the previous week. Answers to each question are on a scale of 0 (None of the time) to 4 (All of the time). Both total OSDI and its subscale scores are on a scale of 0 to 100, calculated as follows: score = (sum of scores for questions answered/number of questions answered) x 25. Higher scores represent greater disability.
Change From Baseline TBUTFrom baseline to Day 30 (Part 3)Tear film break-up time (TBUT) (s)
Change From Baseline Tear OsmolarityFrom baseline to Day 30 (Part 3)Instrumental assay of tear fluid osmolarity (mOsm/L)

Secondary

MeasureTime frameDescription
Change From Baseline Corneal StainingFrom baseline to Day 30 (Part 3)Corneal staining score is assessed as the average number of punctate dots on an ordinal scale of 0, 1, 2, 3, 4, and 5 (Oxford scale) when compared to a pictorial standard. The number of dots increases on a log scale. Higher score represents more intense staining.
Change From Baseline Blink RateFrom baseline to Day 30 (Part 3)Measurement of spontaneous eyelid blinks per minute
Change From Baseline Ocular Protection Index (OPI)From baseline to Day 30 (Part 3)OPI is the ratio of TBUT/IBI (IBI, interblink interval calculated from blink rate). An OPI value \>1 indicates that TBUT (s) exceeds IBI (s) and that the ocular surface is mostly tear-film protected, because tear film break-ups do not take place within spontaneous blink cycles.
Change From Baseline Conjunctival (Temporal) StainingFrom baseline to Day 30 (Part 3)Conjunctival staining score is assessed as the average number of punctate dots on an ordinal scale of 0, 1, 2, 3, 4, and 5 (Oxford scale) when compared to a pictorial standard. The number of dots increases on a log scale. Higher score represents more intense staining.
Change From Baseline Conjunctival (Nasal) StainingFrom baseline to Day 30 (Part 3)Conjunctival staining score is assessed as the average number of punctate dots on an ordinal scale of 0, 1, 2, 3, 4, and 5 (Oxford scale) when compared to a pictorial standard. The number of dots increases on a log scale. Higher score represents more intense staining.

Other

MeasureTime frameDescription
Change From Baseline Conjunctival RednessFrom baseline to Day 30 (Part 3)Conjunctival redness score is assessed on an ordinal scale of 0 to 4 (IER grading scale): 0 = not existing, 1 = very slight, 2 = slight, 3 = moderate, 4 = severe. Higher score represents more intense redness.
Change From Baseline Intraocular PressureFrom baseline to Day 30 (Part 3)Intraocular pressure measured using Goldmann applanation tonometry (mmHg)
Change From Baseline Visual AcuityFrom baseline to Day 30 (Part 3)Best corrected visual acuity (ETDRS charts 1 & 2, 2000 series)
Change From Baseline Lid RednessFrom baseline to Day 30 (Part 3)Eyelid redness score is assessed on an ordinal scale of 0 to 4 (IER grading scale): 0 = not existing, 1 = very slight, 2 = slight, 3 = moderate, 4 = severe. Higher score represents more intense redness.

Countries

Finland

Participant flow

Recruitment details

The study comprised three sequential parts. Parts 1 to 3 involved different participants each, thus no participant flow between parts (or periods) took place.

Participants by arm

ArmCount
Emulsion Eye Drops
Daily treatment with Piiloset Trehalose Emulsion Eye Drops Results are reported for Part 3 only: Topical application of preservative-free multidose Piiloset Trehalose Emulsion Eye Drops on both eyes 3 times a day for 30 days
26
Control Eye Drops
Daily treatment with Hyaluronic Acid Eye Drops (a CE-marked medical device) Results are reported for Part 3 only: Topical application of preservative-free multidose Hyaluronic Acid Eye Drops on both eyes 3 times a day for 30 days
26
Total52

Withdrawals & dropouts

PeriodReasonFG000FG001
Part 3Other11
Part 3Physician Decision10

Baseline characteristics

CharacteristicControl Eye DropsTotalEmulsion Eye Drops
Age, Continuous51.5 years
STANDARD_DEVIATION 11.4
53.3 years
STANDARD_DEVIATION 12.6
55.1 years
STANDARD_DEVIATION 13.8
Allergy0 Participants0 Participants0 Participants
Blink rate22.27 Blinks/min
STANDARD_DEVIATION 12.93
20.22 Blinks/min
STANDARD_DEVIATION 12.28
18.17 Blinks/min
STANDARD_DEVIATION 11.49
Body Weight76.9 kg
STANDARD_DEVIATION 15.8
76.0 kg
STANDARD_DEVIATION 13.8
75.1 kg
STANDARD_DEVIATION 11.7
Conjunctival redness1.94 score on a scale
STANDARD_DEVIATION 0.829
1.96 score on a scale
STANDARD_DEVIATION 0.753
1.98 score on a scale
STANDARD_DEVIATION 0.685
Conjunctival staining (nasal)1.23 score on a scale
STANDARD_DEVIATION 0.406
1.23 score on a scale
STANDARD_DEVIATION 0.414
1.23 score on a scale
STANDARD_DEVIATION 0.43
Conjunctival staining (temporal)1.06 score on a scale
STANDARD_DEVIATION 0.497
1.06 score on a scale
STANDARD_DEVIATION 0.461
1.06 score on a scale
STANDARD_DEVIATION 0.432
Corneal staining1.21 score on a scale
STANDARD_DEVIATION 0.603
1.29 score on a scale
STANDARD_DEVIATION 0.703
1.37 score on a scale
STANDARD_DEVIATION 0.794
Current or planned pregnancy and nursing0 Participants0 Participants0 Participants
Eye infection0 Participants0 Participants0 Participants
Intraocular pressure15.69 mmHg (Goldmann tonometer)
STANDARD_DEVIATION 2.558
15.31 mmHg (Goldmann tonometer)
STANDARD_DEVIATION 2.364
14.92 mmHg (Goldmann tonometer)
STANDARD_DEVIATION 2.134
Lid redness1.29 score on a scale
STANDARD_DEVIATION 0.724
1.29 score on a scale
STANDARD_DEVIATION 0.73
1.29 score on a scale
STANDARD_DEVIATION 0.751
Ocular protection index (OPI)1.23 ratio
STANDARD_DEVIATION 1.188
1.11 ratio
STANDARD_DEVIATION 1.067
0.98 ratio
STANDARD_DEVIATION 0.937
Ocular Surface Disease Index (OSDI)45.6 units on a scale
STANDARD_DEVIATION 11.3
46.9 units on a scale
STANDARD_DEVIATION 11
48.1 units on a scale
STANDARD_DEVIATION 10.8
Ocular surgery, trauma, refractive laser vision correction0 Participants0 Participants0 Participants
Race and Ethnicity Not Collected0 Participants
Region of Enrollment
Finland
26 participants52 participants26 participants
Sex: Female, Male
Female
18 Participants36 Participants18 Participants
Sex: Female, Male
Male
8 Participants16 Participants8 Participants
Tear Break-Up Time (TBUT)3.46 s
STANDARD_DEVIATION 2.04
3.40 s
STANDARD_DEVIATION 2.33
3.35 s
STANDARD_DEVIATION 2.62
Tear osmolarity307.3 mOsm/L
STANDARD_DEVIATION 12.4
305.6 mOsm/L
STANDARD_DEVIATION 12.1
304.0 mOsm/L
STANDARD_DEVIATION 11.8

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
0 / 380 / 35
other
Total, other adverse events
1 / 380 / 35
serious
Total, serious adverse events
0 / 380 / 35

Outcome results

Primary

Change From Baseline OSDI

Ocular Surface Disease Index (OSDI) is a questionnaire consisting of 12 questions subdivided into 3 subscales for measuring the frequency of dry eye symptoms, vision-related quality of life and environmental triggers during the previous week. Answers to each question are on a scale of 0 (None of the time) to 4 (All of the time). Both total OSDI and its subscale scores are on a scale of 0 to 100, calculated as follows: score = (sum of scores for questions answered/number of questions answered) x 25. Higher scores represent greater disability.

Time frame: From baseline to Day 30 (Part 3)

Population: Intent-to-treat (ITT) dataset

ArmMeasureValue (MEAN)Dispersion
Emulsion Eye DropsChange From Baseline OSDI-24.64 units on a scaleStandard Deviation 16.186
Control Eye DropsChange From Baseline OSDI-26.53 units on a scaleStandard Deviation 14.62
Comparison: Between-group comparison, change from baselinep-value: 0.66295% CI: [-6.7081, 10.4756]ANOVA
Comparison: Within-group change from baselinep-value: <0.000195% CI: [-30.7199, -18.5692]ANOVA
Comparison: Within-group change from baselinep-value: <0.000195% CI: [-32.6036, -20.4529]ANOVA
Primary

Change From Baseline TBUT

Tear film break-up time (TBUT) (s)

Time frame: From baseline to Day 30 (Part 3)

Population: Intent-to-treat (ITT) dataset

ArmMeasureValue (MEAN)Dispersion
Emulsion Eye DropsChange From Baseline TBUT1.71 sStandard Deviation 3.424
Control Eye DropsChange From Baseline TBUT0.87 sStandard Deviation 1.809
Comparison: Between-group comparison, change from baselinep-value: 0.27195% CI: [-0.6792, 2.3715]ANOVA
Comparison: Within-group change from baselinep-value: 0.002595% CI: [0.633, 2.7901]ANOVA
Comparison: Within-group change from baselinep-value: 0.113495% CI: [-0.2132, 1.944]ANOVA
Primary

Change From Baseline Tear Osmolarity

Instrumental assay of tear fluid osmolarity (mOsm/L)

Time frame: From baseline to Day 30 (Part 3)

Population: Intent-to-treat (ITT) dataset

ArmMeasureValue (MEAN)Dispersion
Emulsion Eye DropsChange From Baseline Tear Osmolarity-4.75 mOsm/LStandard Deviation 16.224
Control Eye DropsChange From Baseline Tear Osmolarity-1.77 mOsm/LStandard Deviation 21.531
Comparison: Between-group comparison, change from baselinep-value: 0.57595% CI: [-13.6005, 7.639]ANOVA
Comparison: Within-group change from baselinep-value: 0.209895% CI: [-12.2593, 2.7593]ANOVA
Comparison: Within-group change from baselinep-value: 0.638195% CI: [-9.2785, 5.7401]ANOVA
Secondary

Change From Baseline Blink Rate

Measurement of spontaneous eyelid blinks per minute

Time frame: From baseline to Day 30 (Part 3)

Population: Intent-to-treat (ITT) dataset

ArmMeasureValue (MEAN)Dispersion
Emulsion Eye DropsChange From Baseline Blink Rate0.02 Blinks/minStandard Deviation 8.721
Control Eye DropsChange From Baseline Blink Rate-2.15 Blinks/minStandard Deviation 10.161
Comparison: Between-group comparison, change from baselinep-value: 0.41295% CI: [-3.1016, 7.4477]ANOVA
Comparison: Within-group change from baselinep-value: 0.991895% CI: [-3.7105, 3.749]ANOVA
Comparison: Within-group change from baselinep-value: 0.251695% CI: [-5.8836, 1.5759]ANOVA
Secondary

Change From Baseline Conjunctival (Nasal) Staining

Conjunctival staining score is assessed as the average number of punctate dots on an ordinal scale of 0, 1, 2, 3, 4, and 5 (Oxford scale) when compared to a pictorial standard. The number of dots increases on a log scale. Higher score represents more intense staining.

Time frame: From baseline to Day 30 (Part 3)

Population: Per-protocol (PP) dataset

ArmMeasureValue (MEAN)Dispersion
Emulsion Eye DropsChange From Baseline Conjunctival (Nasal) Staining-0.27 score on a scaleStandard Deviation 0.608
Control Eye DropsChange From Baseline Conjunctival (Nasal) Staining-0.12 score on a scaleStandard Deviation 0.666
Comparison: Between-group comparison, change from baselinep-value: 0.59Wilcoxon rank sum test
Comparison: Within-group change from baselinep-value: 0.043Wilcoxon rank sum test
Comparison: Within-group change from baselinep-value: 0.442Wilcoxon rank sum test
Secondary

Change From Baseline Conjunctival (Temporal) Staining

Conjunctival staining score is assessed as the average number of punctate dots on an ordinal scale of 0, 1, 2, 3, 4, and 5 (Oxford scale) when compared to a pictorial standard. The number of dots increases on a log scale. Higher score represents more intense staining.

Time frame: From baseline to Day 30 (Part 3)

Population: Per-protocol (PP) dataset

ArmMeasureValue (MEAN)Dispersion
Emulsion Eye DropsChange From Baseline Conjunctival (Temporal) Staining-0.19 score on a scaleStandard Deviation 0.507
Control Eye DropsChange From Baseline Conjunctival (Temporal) Staining-0.02 score on a scaleStandard Deviation 0.81
Comparison: Between-group comparison, change from baselinep-value: 0.522Wilcoxon rank sum test
Comparison: Within-group change from baselinep-value: 0.119Wilcoxon rank sum test
Comparison: Within-group change from baselinep-value: 0.9Wilcoxon rank sum test
Secondary

Change From Baseline Corneal Staining

Corneal staining score is assessed as the average number of punctate dots on an ordinal scale of 0, 1, 2, 3, 4, and 5 (Oxford scale) when compared to a pictorial standard. The number of dots increases on a log scale. Higher score represents more intense staining.

Time frame: From baseline to Day 30 (Part 3)

Population: Per-protocol (PP) dataset

ArmMeasureValue (MEAN)Dispersion
Emulsion Eye DropsChange From Baseline Corneal Staining-0.38 score on a scaleStandard Deviation 0.695
Control Eye DropsChange From Baseline Corneal Staining-0.22 score on a scaleStandard Deviation 0.522
Comparison: Between-group comparison, change from baselinep-value: 0.447Wilcoxon rank sum test
Comparison: Within-group change from baselinep-value: 0.014Wilcoxon rank sum test
Comparison: Within-group change from baselinep-value: 0.07Wilcoxon rank sum test
Secondary

Change From Baseline Ocular Protection Index (OPI)

OPI is the ratio of TBUT/IBI (IBI, interblink interval calculated from blink rate). An OPI value \>1 indicates that TBUT (s) exceeds IBI (s) and that the ocular surface is mostly tear-film protected, because tear film break-ups do not take place within spontaneous blink cycles.

Time frame: From baseline to Day 30 (Part 3)

Population: Intent-to-treat (ITT) dataset

ArmMeasureValue (MEAN)Dispersion
Emulsion Eye DropsChange From Baseline Ocular Protection Index (OPI)0.56 ratioStandard Deviation 1.078
Control Eye DropsChange From Baseline Ocular Protection Index (OPI)0.05 ratioStandard Deviation 0.68
Comparison: Between-group comparison, change from baselinep-value: 0.04795% CI: [0.007267, 1.0113]ANOVA
Comparison: Within-group change from baselinep-value: 0.002695% CI: [0.2046, 0.9146]ANOVA
Comparison: Within-group change from baselinep-value: 0.77795% CI: [-0.3047, 0.4053]ANOVA
Other Pre-specified

Change From Baseline Conjunctival Redness

Conjunctival redness score is assessed on an ordinal scale of 0 to 4 (IER grading scale): 0 = not existing, 1 = very slight, 2 = slight, 3 = moderate, 4 = severe. Higher score represents more intense redness.

Time frame: From baseline to Day 30 (Part 3)

Population: Safety dataset

ArmMeasureValue (MEAN)Dispersion
Emulsion Eye DropsChange From Baseline Conjunctival Redness-0.46 score on a scaleStandard Deviation 0.647
Control Eye DropsChange From Baseline Conjunctival Redness-0.27 score on a scaleStandard Deviation 0.652
Comparison: Between-group comparison, change from baselinep-value: 0.357Wilcoxon rank sum test
Comparison: Within-group change from baselinep-value: 0.001Wilcoxon rank sum test
Comparison: Within-group change from baselinep-value: 0.065Wilcoxon rank sum test
Other Pre-specified

Change From Baseline Intraocular Pressure

Intraocular pressure measured using Goldmann applanation tonometry (mmHg)

Time frame: From baseline to Day 30 (Part 3)

Population: Safety dataset

ArmMeasureValue (MEAN)Dispersion
Emulsion Eye DropsChange From Baseline Intraocular Pressure-0.12 mmHgStandard Deviation 1.705
Control Eye DropsChange From Baseline Intraocular Pressure-0.42 mmHgStandard Deviation 1.653
Other Pre-specified

Change From Baseline Lid Redness

Eyelid redness score is assessed on an ordinal scale of 0 to 4 (IER grading scale): 0 = not existing, 1 = very slight, 2 = slight, 3 = moderate, 4 = severe. Higher score represents more intense redness.

Time frame: From baseline to Day 30 (Part 3)

Population: Safety dataset

ArmMeasureValue (MEAN)Dispersion
Emulsion Eye DropsChange From Baseline Lid Redness-0.37 score on a scaleStandard Deviation 0.672
Control Eye DropsChange From Baseline Lid Redness-0.19 score on a scaleStandard Deviation 0.549
Comparison: Between-group comparison, change from baselinep-value: 0.296Wilcoxon rank sum test
Comparison: Within-group change from baselinep-value: 0.012Wilcoxon rank sum test
Comparison: Within-group change from baselinep-value: >0.05Wilcoxon rank sum test
Post Hoc

Change From Baseline Tear Osmolarity in Hyperosmolar Participants

Instrumental assay of tear fluid osmolarity (mOsm/L) in a hyperosmolar subgroup of participants (mean of eyes ≥308 mOsm/L)

Time frame: From baseline to Day 30 (Part 3)

Population: ITT population with hyperosmolar tears (mean of eyes ≥308 mOsm/L)

ArmMeasureValue (MEAN)Dispersion
Emulsion Eye DropsChange From Baseline Tear Osmolarity in Hyperosmolar Participants-17.06 mOsm/LStandard Deviation 10.425
Control Eye DropsChange From Baseline Tear Osmolarity in Hyperosmolar Participants-15.07 mOsm/LStandard Deviation 16.596
Comparison: Between-group comparison, change from baselinep-value: 0.76495% CI: [-15.6117, 11.6295]ANOVA
Comparison: Within-group change from baselinep-value: 0.003895% CI: [-27.928, -6.197]ANOVA
Comparison: Within-group change from baselinep-value: 0.001195% CI: [-23.285, -6.8579]ANOVA
Other Pre-specified

Change From Baseline Visual Acuity

Best corrected visual acuity (ETDRS charts 1 & 2, 2000 series)

Time frame: From baseline to Day 30 (Part 3)

Population: Safety dataset

ArmMeasureValue (MEAN)Dispersion
Emulsion Eye DropsChange From Baseline Visual Acuity-0.03 logMAR chart log unitsStandard Deviation 0.071
Control Eye DropsChange From Baseline Visual Acuity-0.04 logMAR chart log unitsStandard Deviation 0.08

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026