Low dose naltraxone effective for neuropathic corneal pain,finds study

In this retrospective study ,researchers assessed the efficacy and tolerability of low-dose naltrexone (LDN) in refractory NCP patients.

For the study design,Fifty-nine NCP patients with a centralized component treated with oral LDN 4.5 mg at bedtime for at least four weeks were identified. Thirty out of 59 patients who had a baseline pain score ≥4 on the visual analogue scale had completed the ocular pain assessment survey (OPAS) and presented persistent pain, despite instillation of topical anesthetic drops, were included. Changes in pain scores, comorbidities, side effects, among others, were analyzed. Change in ocular pain scores (scale 0-10) and quality of life (QoL) scores (scale 0-100%) were the main endpoints.

Data analysis revealed the following facts.

· Mean age (years ± SD) was 45.60 ± 19.30 with a white (80.00%) female (73.33%) predominance. Duration of LDN use was 14.87 ± 11.25 months, and the duration of NCP before treatment was 17.53 ± 17.29 months.

· Eight patients used LDN as a monotherapy, whereas the remaining used it as an adjunct therapy.

· LDN resulted in a 49.22% decrease in mean pain score from 6.13 ± 1.93 to 3.23 ± 2.60 (p < 0.001).

· Mean QoL scores by the OPAS were 5.84 ± 2.57 at the first visit and improved to 3.77 ± 2.91 at the last visit (p = 0.023).

· Common side effects were vivid dreams, headaches, and stomach ache.

"Taking into account the limited number of therapeutic options and the positive efficacy and tolerability profile of LDN, this medication could be considered as an alternative therapeutic modality for the treatment of patients with refractory NCP,"the team wrote.

For the full article follow the link: Low-dose naltrexone is effective and well-tolerated for modulating symptoms in patients with neuropathic corneal pain. Ocul Surf. Published online January 12, 2021. doi:10.1016/j.jtos.2020

Primary source: The Ocular Surface