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Low-dose naltrexone is effective and well-tolerated for modulating symptoms in patients with neuropathic corneal pain
The Ocular Surface ( IF 6.4 ) Pub Date : 2021-01-12 , DOI: 10.1016/j.jtos.2020.12.003
Gabriela Dieckmann 1 , M Cuneyt Ozmen 1 , Stephanie M Cox 1 , Ryan C Engert 2 , Pedram Hamrah 1
Affiliation  

Purpose

Neuropathic corneal pain (NCP) is caused by damage or disease of the somatosensory nervous system that innervates the cornea and presents with symptoms of pain or persistent unpleasant sensations, such as burning, dryness, or light sensitivity. This retrospective study aims to assess the efficacy and tolerability of low-dose naltrexone (LDN) in refractory NCP patients.

Methods

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.

Results

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 stomachache.

Conclusion

LDN was effective and well-tolerated for NCP treatment.



中文翻译:

低剂量纳曲酮对调节神经性角膜疼痛患者的症状有效且耐受性良好

目的

神经性角膜疼痛 (NCP) 是由支配角膜的躯体感觉神经系统的损伤或疾病引起的,并出现疼痛症状或持续的不愉快感觉,例如灼热、干燥或光敏感。这项回顾性研究旨在评估低剂量纳曲酮 (LDN) 在难治性 NCP 患者中的疗效和耐受性。

方法

确定了 59 名具有集中成分的 NCP 患者,在睡前使用口服 LDN 4.5 mg 治疗至少 4 周。在视觉模拟评分中基线疼痛评分≥4 的 59 名患者中,有 30 名完成了眼部疼痛评估调查 (OPAS),并且尽管滴入了局部麻醉剂,但仍出现持续疼痛。分析了疼痛评分、合并症、副作用等方面的变化。眼痛评分(0-10 级)和生活质量(QoL)评分(0-100%)的变化是主要终点。

结果

平均年龄(岁 ± SD)为 45.60 ± 19.30,其中白人(80.00%)女性(73.33%)占优势。LDN使用持续时间为14.87±11.25个月,治疗前NCP持续时间为17.53±17.29个月。8 名患者将 LDN 用作单一疗法,而其余患者将其用作辅助疗法。LDN 导致平均疼痛评分从 6.13 ± 1.93 降低 49.22% 至 3.23 ± 2.60 (p < 0.001)。OPAS 的平均 QoL 得分在第一次访问时为 5.84 ± 2.57,在最后一次访问时提高到 3.77 ± 2.91 (p = 0.023)。常见的副作用是生动的梦境、头痛和胃痛。

结论

LDN 对 NCP 治疗有效且耐受性良好。

更新日期:2021-01-18
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