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Effect of Topical Naltrexone Ophthalmic Solution on the Signs and Symptoms of Dry Eye in Diabetic Subjects

A Single-Center, Randomized, Double Masked, Placebo Controlled Clinical Study to Assess the Safety and Efficacy of Topical Naltrexone Ophthalmic Solution on the Signs and Symptoms of Dry Eye in Diabetic Subjects

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT03660475
Enrollment
60
Registered
2018-09-06
Start date
2018-07-31
Completion date
2018-11-15
Last updated
2022-12-02

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

Conditions

Dry Eye Disease

Keywords

naltrexone, dry eye, diabetic subjects

Brief summary

The objective of this exploratory study is to determine the safety and efficacy of 0.002% Naltrexone Ophthalmic Solution, compared to placebo for the treatment of the signs and symptoms of dry eye in diabetic subjects.

Detailed description

This is a Phase 2, single-center, double-masked, randomized, placebo-controlled study to compare the safety and efficacy of Naltrexone Ophthalmic Solution, 0.002% to placebo for the treatment of the signs and symptoms of dry eye in diabetic subjects. Subjects eligible to be randomized will receive one of the following treatments to be administered bilaterally BID for 29 days (from Visit 2 to Visit 5): Naltrexone Ophthalmic Solution, 0.002% or Placebo Ophthalmic Solution (Vehicle). During a 10-day study run-in period (for the purpose of subject selection) prior to randomization, all subjects will receive Placebo Ophthalmic Solution (Vehicle) bilaterally BID. Participants who terminate early during the application period will be asked to complete safety assessments (if the participants agree) prior to study exit. Participants who are terminated early from the study will not be replaced.

Interventions

DRUGNaltrexone

naltrexone formulated as ophthalmic solution

DRUGPlacebos

Placebo ophthalmic solution

Sponsors

Sassani, Joseph S., MD, MHA
Lead SponsorINDIV

Study design

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

Eligibility

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

Inclusion criteria

* Provide written informed consent; * Have a diagnosis of type 1 or type 2 diabetes mellitus prior to Visit 1; * Have a reported history of dry eye for at least 6 months prior to Visit 1; * Have a history of use or desire to use eye drops for dry eye symptoms within 6 months of Visit 1; * Have a corneal fluorescein staining score of ≥ 2 in any region (inferior, superior, or central regions) in at least one eye at Visits 1 and 2 (must be the same eye at Visits 1 and 2); * Have at least one of the following at Visits 1 and 2: 1. A total lissamine green conjunctival score of ≥ 2 in at least one eye, based on the sum of the temporal and nasal regions at Visits 1 and 2 (must be the same eye at Visits 1 and 2); 2. Report an OSDI score ≥ 20 at Visits 1 and 2.

Exclusion criteria

* Have any clinically significant slit lamp findings at Visit 1 that may include active blepharitis, meibomian gland dysfunction (MGD), lid margin inflammation or active ocular allergies that require therapeutic treatment, and/or in the opinion of the investigator may interfere with study parameters; * Be diagnosed with an ongoing ocular infection (bacterial, viral, or fungal), or active ocular inflammation at Visit 1; * Have concurrent neurotrophic keratopathy from a source other than diabetes (h/o HSV keratitis, h/o HZO with ocular manifestations, or CN VII palsy or other condition resulting in lagophthalmos); * Have active diabetic foot ulcers; * Have a corneal sensitivity score ≤ 1.5 cm as measured by Cochet-Bonnet at Visit 1; * Report an OSDI score \> 75 at Visits 1 and 2; * Have worn contact lenses within 21 days of Visit 1 or anticipate using contact lenses during the study (no contact lens wear during study); * Have used any eye drops within 2 hours of Visit 1; * Have previously had laser-assisted in situ keratomileusis (LASIK) surgery within the last 24 months; * Have used cyclosporine 0.05% or lifitigrast 5.0% ophthalmic solution within 45 days of Visit 1; * Have any planned ocular and/or lid surgeries over the study period or any ocular surgery within the last 12 months; * Be using or anticipate using temporary punctal plugs during the study that have not been stable within 30 days of Visit 1; * Be currently taking any topical ophthalmic prescription (including medications for glaucoma) or over-the-counter (OTC) solutions, artificial tears, gels or scrubs, and cannot discontinue these medications for the duration of the trial (excluding medications allowed for the conduct of the study); * Have corrected visual acuity greater than or equal to logMAR +0.7 as assessed by Early Treatment of Diabetic Retinopathy Study (ETDRS) scale in either eye at Visit 1; * Have concurrent autoimmune disease causing dry eye (e.g., rheumatoid arthritis, Sjogren's, GVHD, Steven's Johnson, Grave's); * Have Fuchs endothelial dystrophy; * Have recurrent corneal erosion syndrome or anterior basement membrane dystrophy; * Be a woman who is pregnant, nursing, or planning a pregnancy; * Be unwilling to submit a urine pregnancy test at Visit 1 and Visit 5 (or early termination visit) if of childbearing potential. Non-childbearing potential is defined as a woman who is permanently sterilized (i.e., has had a hysterectomy or bilateral tubal ligation), or is post-menopausal (without menses for 12 consecutive months); * Be a woman of childbearing potential who is not using an acceptable means of birth control; acceptable methods of contraception include: hormonal - oral, implantable, injectable, or transdermal contraceptives; mechanical - spermicide in conjunction with a barrier such as a diaphragm or condom; IUD; or surgical sterilization of partner. For non-sexually active females, abstinence may be regarded as an adequate method of birth control; however, if the subject becomes sexually active during the study, they must agree to use adequate birth control as defined above for the remainder of the study; * Have a known allergy and/or sensitivity to the test article or its components; * Have a condition or be in a situation which the investigator feels may put the subject at significant risk, may confound the study results, or may interfere significantly with the subject's participation in the study; * Be currently enrolled in an investigational drug or device study or have used an investigational drug or device within 30 days of Visit 1; * Be currently using any medication known to cause ocular drying that is not used on a stable dosing regimen for at least 30 days prior to Visit 1; * Be unable or unwilling to follow instructions, including participation in all study assessments and visits. * Be currently using a systemic opioid antagonist (e.g., Naltrexone or Naloxone) or have used a systemic opioid antagonist in the previous 90 days

Design outcomes

Primary

MeasureTime frameDescription
Total Ocular Surface Disease IndexDay 29The OSDI is a 12-item questionnaire designed to provide a rapid assessment of the symptoms of ocular irritation consistent with dry eye disease and their impact on vision-related functioning. It is a scale of 0-4 for each of the 12 questions. A minimum value would be 0 and a maximum value would be 48. The higher the value the worse the outcome.

Secondary

MeasureTime frameDescription
Tear Film Break-up TimeDay 29Tear film break-up time is the time taken for the first dry spot to appear on the cornea after a complete blink.
Conjunctival RednessDay 29Conjunctival redness will be assessed and conjunctival pain will be assessed using a visual analog scale ranging from 0 (none: normal without vasodilation) to 5 (severe: broad ciliary and prominent, horizontal conjunctival vasodilation). A minimal score would be 0 and a maximal score would be 10. The higher the value the worse the outcome .
Schirmer's TestDay 29Schirmer's Test (without anesthesia) ) involves placing a Schirmer test strip in the lower temporal lid margin of each eye such that the strip fits tightly. Subjects will be instructed to close their eyes. After 5 minutes have elapsed, the Schirmer strip will be removed. The length of the moistened area will be recorded (mm) for each eye. A normal reading is ≥10 mm wetting of the paper after 5 minutes. Tear deficiency is \<5 mm wetting of the paper after 5 minutes.
Cochet-Bonnet Corneal Sensitivity TestDay 29After extending the Cochet-Bonnet corneal sensitivity device (containing a thin, retractable, nylon monofilament) up to 6 cm in length and pressing against the cornea, the monofilament is slowly retracted incrementally in 0.5 cm steps until the patient can feel its contact and the length is recorded. The greater the length indicates increased sensation and the shorter the length indicates decreased sensation.
Tear OsmolarityDay 29Normal tear osmolarity is defined as \< 300 mOsm/L in both eyes and an inter-eye difference of \< 8 mOsm/L. Values greater than 300 mOsm/L are suggestive of dry eye.
Matrix Metalloprotienase-9 (MMP-9) is a Marker of Inflammation.Day 29Levels of MMP-9 will be measured in each eye using InflammaDry at Visit 5. The test will be recorded as either positive or negative. Dry eye patients generally exhibit positive levels of MMP-9., so the number of subjects testing positive for MMP-9 at Day 29 will be recorded.
Ocular Discomfort (Scale 1)Day 29Ocular discomfort scores will be subjectively graded by the subjects according to the following scale, rating each eye separately on a scale from 0-4. A score of 0 represents no discomfort and a score of 4 represents constant discomfort. A minimum score would be 0 and a maximum score would be 8. The higher the value the worse the outcome.
Ocular Discomfort (Scale 2)Day 29Subjects will rate the severity of each of the following symptoms, with regard to how both their eyes feel: overall ocular discomfort, burning, dryness, grittiness and stinging according to the following 6-point (0 to 5) scale where 0 = none and 5 = worst. A minimum score would be 0 and a maximum score would be 10. The higher the value the worse the outcome.
Visual Analog Scale for PainDay 29Standard scale assessing a patient's level of pain on a scale of 0-100. The subject will be asked to rate each ocular symptom due to ocular dryness by placing a vertical mark on the horizontal line to indicate the level of discomfort. 0% corresponds to no discomfort and 100% corresponds to maximal discomfort. The following parameters will be assessed: burning/stinging, itching, foreign body sensation, blurred vision, eye dryness, photophobia, and pain, with a total score for each eye reported. A minimal score would be 0 and a maximum score would be 200. The higher the value the worse the outcome.
Fluorescein StainingDay 29The following regions of each eye will be assessed for fluorescein staining: inferior, superior, central, corneal sum, temporal, nasal, conjunctival sum, and a total eye score recorded. A score of 0 represents no staining and a score of 4 represents confluent staining. A minimum score would be 0 and a maximum score would be 8. A higher values represent a worse outcome.
Visual Acuity Measured by Assessing Average Change in LogMAR Units for Both Eyes at Day 29. LogMAR Units Range From 0-1.0, With the Higher the Number Indicating a Worsening in Vision.Day 29Mean change in visual acuity (LogMAR units 0-1.0) for both eyes at Day 29 was determined for each treatment arm and considered a measure of safety.
Lissamine Green StainingDay 29Lissamine green staining; regions: inferior, superior, central, corneal sum, temporal, nasal, conjunctival sum, total eye will be measured using an ocular discomfort score on a scale of 0 (no staining) to 4 (confluent staining). The total eye score is presented. A minimum score would be 0 and a maximal score would be 8. The higher the value the worse the outcome.

Other

MeasureTime frameDescription
Number of Participants With Treatment-related Adverse EventsAdverse events will be collected from first dose of study drug to 30 days after treatment discontinuation (Day 29 + 4 weeks).An adverse event is defined as any untoward medical occurrence associated with the use of the investigational agent (or placebo) regardless of whether or not it is considered related to the investigational drug (or placebo).
Slit-lamp BiomicroscopyDay 29The binocular slit-lamp examination provides a stereoscopic magnified view of the eye structures in detail, enabling anatomical diagnoses to be made of the cornea, conjunctiva, anterior chamber, iris, lens and lid for both eyes. The number of subjects in each treatment arm that have changes in the cornea, conjunctiva, anterior chamber, iris, lens and lid for both eyes at Day 29 will be reported.
Intraocular PressureDay 29Intraocular pressure is the fluid pressure inside the eye.
Dilated FundoscopyDay 29Dilated fundus examination is a diagnostic procedure that employs the use of mydriatic eye drops to dilate the pupil in order to obtain a better view of the fundus of the eye. The number of subjects that demonstrate clinically significant abnormalities in the vitreous, choroid, macula, and optic nerve at Day 29 in either treatment arm will be reported.

Countries

United States

Participant flow

Recruitment details

Sixty subjects (30 subjects per treatment arm) were planned. For this number, it was anticipated that 120 subjects would be screened. A total of 87 subjects were screened to enroll 60 subjects who were analyzed for efficacy and safety.

Participants by arm

ArmCount
Naltrexone
Naltrexone Ophthalmic Solution 0.002% Naltrexone: naltrexone formulated as ophthalmic solution
30
Placebo
Placebo Ophthalmic Solution Placebos: Placebo ophthalmic solution
30
Total60

Baseline characteristics

CharacteristicNaltrexoneTotalPlacebo
Age, Continuous65.64 years
STANDARD_DEVIATION 7.86
64.14 years
STANDARD_DEVIATION 9.58
62.64 years
STANDARD_DEVIATION 10.97
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Asian
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Black or African American
20 Participants41 Participants21 Participants
Race (NIH/OMB)
More than one race
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants
Race (NIH/OMB)
White
10 Participants19 Participants9 Participants
Region of Enrollment
United States
30 participants60 participants30 participants
Sex: Female, Male
Female
17 Participants35 Participants18 Participants
Sex: Female, Male
Male
13 Participants25 Participants12 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
0 / 300 / 30
other
Total, other adverse events
0 / 301 / 30
serious
Total, serious adverse events
0 / 300 / 30

Outcome results

Primary

Total Ocular Surface Disease Index

The OSDI is a 12-item questionnaire designed to provide a rapid assessment of the symptoms of ocular irritation consistent with dry eye disease and their impact on vision-related functioning. It is a scale of 0-4 for each of the 12 questions. A minimum value would be 0 and a maximum value would be 48. The higher the value the worse the outcome.

Time frame: Day 29

ArmMeasureValue (MEAN)Dispersion
NaltrexoneTotal Ocular Surface Disease Index21.17 score on a scaleStandard Deviation 17.72
PlaceboTotal Ocular Surface Disease Index21.36 score on a scaleStandard Deviation 17.16
p-value: 0.967t-test, 2 sided
Secondary

Cochet-Bonnet Corneal Sensitivity Test

After extending the Cochet-Bonnet corneal sensitivity device (containing a thin, retractable, nylon monofilament) up to 6 cm in length and pressing against the cornea, the monofilament is slowly retracted incrementally in 0.5 cm steps until the patient can feel its contact and the length is recorded. The greater the length indicates increased sensation and the shorter the length indicates decreased sensation.

Time frame: Day 29

ArmMeasureValue (MEAN)Dispersion
NaltrexoneCochet-Bonnet Corneal Sensitivity Test59.78 cmStandard Deviation 0.95
PlaceboCochet-Bonnet Corneal Sensitivity Test59.37 cmStandard Deviation 1.44
p-value: 0.2t-test, 2 sided
Secondary

Conjunctival Redness

Conjunctival redness will be assessed and conjunctival pain will be assessed using a visual analog scale ranging from 0 (none: normal without vasodilation) to 5 (severe: broad ciliary and prominent, horizontal conjunctival vasodilation). A minimal score would be 0 and a maximal score would be 10. The higher the value the worse the outcome .

Time frame: Day 29

ArmMeasureValue (MEAN)Dispersion
NaltrexoneConjunctival Redness1.0 score on a scaleStandard Deviation 0.41
PlaceboConjunctival Redness1.0 score on a scaleStandard Deviation 0.45
p-value: 0.638t-test, 2 sided
Secondary

Fluorescein Staining

The following regions of each eye will be assessed for fluorescein staining: inferior, superior, central, corneal sum, temporal, nasal, conjunctival sum, and a total eye score recorded. A score of 0 represents no staining and a score of 4 represents confluent staining. A minimum score would be 0 and a maximum score would be 8. A higher values represent a worse outcome.

Time frame: Day 29

ArmMeasureValue (MEAN)Dispersion
NaltrexoneFluorescein Staining7.70 score on a scaleStandard Deviation 2.53
PlaceboFluorescein Staining7.14 score on a scaleStandard Deviation 3.23
p-value: 0.459t-test, 2 sided
Secondary

Lissamine Green Staining

Lissamine green staining; regions: inferior, superior, central, corneal sum, temporal, nasal, conjunctival sum, total eye will be measured using an ocular discomfort score on a scale of 0 (no staining) to 4 (confluent staining). The total eye score is presented. A minimum score would be 0 and a maximal score would be 8. The higher the value the worse the outcome.

Time frame: Day 29

ArmMeasureValue (MEAN)Dispersion
NaltrexoneLissamine Green Staining2.65 score on a scaleStandard Deviation 1.1
PlaceboLissamine Green Staining2.59 score on a scaleStandard Deviation 1.25
p-value: 0.836t-test, 2 sided
Secondary

Matrix Metalloprotienase-9 (MMP-9) is a Marker of Inflammation.

Levels of MMP-9 will be measured in each eye using InflammaDry at Visit 5. The test will be recorded as either positive or negative. Dry eye patients generally exhibit positive levels of MMP-9., so the number of subjects testing positive for MMP-9 at Day 29 will be recorded.

Time frame: Day 29

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
NaltrexoneMatrix Metalloprotienase-9 (MMP-9) is a Marker of Inflammation.3 Participants
PlaceboMatrix Metalloprotienase-9 (MMP-9) is a Marker of Inflammation.3 Participants
Secondary

Ocular Discomfort (Scale 1)

Ocular discomfort scores will be subjectively graded by the subjects according to the following scale, rating each eye separately on a scale from 0-4. A score of 0 represents no discomfort and a score of 4 represents constant discomfort. A minimum score would be 0 and a maximum score would be 8. The higher the value the worse the outcome.

Time frame: Day 29

ArmMeasureValue (MEAN)Dispersion
NaltrexoneOcular Discomfort (Scale 1)1.03 score on a scaleStandard Deviation 1.1
PlaceboOcular Discomfort (Scale 1)1.07 score on a scaleStandard Deviation 1.13
p-value: 0.903t-test, 2 sided
Secondary

Ocular Discomfort (Scale 2)

Subjects will rate the severity of each of the following symptoms, with regard to how both their eyes feel: overall ocular discomfort, burning, dryness, grittiness and stinging according to the following 6-point (0 to 5) scale where 0 = none and 5 = worst. A minimum score would be 0 and a maximum score would be 10. The higher the value the worse the outcome.

Time frame: Day 29

ArmMeasureValue (MEAN)Dispersion
NaltrexoneOcular Discomfort (Scale 2)1.40 score on a scaleStandard Deviation 1.25
PlaceboOcular Discomfort (Scale 2)1.45 score on a scaleStandard Deviation 1.57
p-value: 0.898t-test, 2 sided
Secondary

Schirmer's Test

Schirmer's Test (without anesthesia) ) involves placing a Schirmer test strip in the lower temporal lid margin of each eye such that the strip fits tightly. Subjects will be instructed to close their eyes. After 5 minutes have elapsed, the Schirmer strip will be removed. The length of the moistened area will be recorded (mm) for each eye. A normal reading is ≥10 mm wetting of the paper after 5 minutes. Tear deficiency is \<5 mm wetting of the paper after 5 minutes.

Time frame: Day 29

ArmMeasureValue (MEAN)Dispersion
NaltrexoneSchirmer's Test8.97 mmStandard Deviation 8
PlaceboSchirmer's Test12.48 mmStandard Deviation 9.2
p-value: 0.122t-test, 2 sided
Secondary

Tear Film Break-up Time

Tear film break-up time is the time taken for the first dry spot to appear on the cornea after a complete blink.

Time frame: Day 29

ArmMeasureValue (MEAN)Dispersion
NaltrexoneTear Film Break-up Time2.76 secondsStandard Deviation 0.98
PlaceboTear Film Break-up Time3.48 secondsStandard Deviation 2.49
p-value: 0.166t-test, 2 sided
Secondary

Tear Osmolarity

Normal tear osmolarity is defined as \< 300 mOsm/L in both eyes and an inter-eye difference of \< 8 mOsm/L. Values greater than 300 mOsm/L are suggestive of dry eye.

Time frame: Day 29

ArmMeasureValue (MEAN)Dispersion
NaltrexoneTear Osmolarity304.31 mOsm/LStandard Deviation 14.11
PlaceboTear Osmolarity310.66 mOsm/LStandard Deviation 12.16
p-value: 0.085t-test, 2 sided
Secondary

Visual Acuity Measured by Assessing Average Change in LogMAR Units for Both Eyes at Day 29. LogMAR Units Range From 0-1.0, With the Higher the Number Indicating a Worsening in Vision.

Mean change in visual acuity (LogMAR units 0-1.0) for both eyes at Day 29 was determined for each treatment arm and considered a measure of safety.

Time frame: Day 29

Population: Mean change in visual acuity for both eyes measured by LogMAR units (0-1.0)

ArmMeasureValue (MEAN)Dispersion
NaltrexoneVisual Acuity Measured by Assessing Average Change in LogMAR Units for Both Eyes at Day 29. LogMAR Units Range From 0-1.0, With the Higher the Number Indicating a Worsening in Vision.0.08 units on a scaleStandard Deviation 0.11
PlaceboVisual Acuity Measured by Assessing Average Change in LogMAR Units for Both Eyes at Day 29. LogMAR Units Range From 0-1.0, With the Higher the Number Indicating a Worsening in Vision.0.07 units on a scaleStandard Deviation 0.13
Secondary

Visual Analog Scale for Pain

Standard scale assessing a patient's level of pain on a scale of 0-100. The subject will be asked to rate each ocular symptom due to ocular dryness by placing a vertical mark on the horizontal line to indicate the level of discomfort. 0% corresponds to no discomfort and 100% corresponds to maximal discomfort. The following parameters will be assessed: burning/stinging, itching, foreign body sensation, blurred vision, eye dryness, photophobia, and pain, with a total score for each eye reported. A minimal score would be 0 and a maximum score would be 200. The higher the value the worse the outcome.

Time frame: Day 29

ArmMeasureValue (MEAN)Dispersion
NaltrexoneVisual Analog Scale for Pain16.27 score on a scaleStandard Deviation 22.82
PlaceboVisual Analog Scale for Pain25.07 score on a scaleStandard Deviation 31.32
p-value: 0.221t-test, 2 sided
Other Pre-specified

Dilated Fundoscopy

Dilated fundus examination is a diagnostic procedure that employs the use of mydriatic eye drops to dilate the pupil in order to obtain a better view of the fundus of the eye. The number of subjects that demonstrate clinically significant abnormalities in the vitreous, choroid, macula, and optic nerve at Day 29 in either treatment arm will be reported.

Time frame: Day 29

ArmMeasureValue (NUMBER)
NaltrexoneDilated Fundoscopy0 participants
PlaceboDilated Fundoscopy0 participants
Other Pre-specified

Intraocular Pressure

Intraocular pressure is the fluid pressure inside the eye.

Time frame: Day 29

ArmMeasureValue (MEAN)Dispersion
NaltrexoneIntraocular Pressure14.95 mmHgStandard Deviation 3.3
PlaceboIntraocular Pressure14.65 mmHgStandard Deviation 2.9
Other Pre-specified

Number of Participants With Treatment-related Adverse Events

An adverse event is defined as any untoward medical occurrence associated with the use of the investigational agent (or placebo) regardless of whether or not it is considered related to the investigational drug (or placebo).

Time frame: Adverse events will be collected from first dose of study drug to 30 days after treatment discontinuation (Day 29 + 4 weeks).

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
NaltrexoneNumber of Participants With Treatment-related Adverse Events0 Participants
PlaceboNumber of Participants With Treatment-related Adverse Events1 Participants
Other Pre-specified

Slit-lamp Biomicroscopy

The binocular slit-lamp examination provides a stereoscopic magnified view of the eye structures in detail, enabling anatomical diagnoses to be made of the cornea, conjunctiva, anterior chamber, iris, lens and lid for both eyes. The number of subjects in each treatment arm that have changes in the cornea, conjunctiva, anterior chamber, iris, lens and lid for both eyes at Day 29 will be reported.

Time frame: Day 29

ArmMeasureValue (NUMBER)
NaltrexoneSlit-lamp Biomicroscopy0 participants
PlaceboSlit-lamp Biomicroscopy0 participants

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