The COAT trial was a multilabel phase 4 study that evaluated the efficacy of a 0.09% cyclosporine solution administered twice daily to patients over a 28-day period. Assessments occurred at baseline and on days 7, 14, and 28, tracking various clinical parameters. The results demonstrated notable improvements not only in best corrected visual acuity but also in corneal fluorescein staining, higher-order aberrations, conjunctival redness, patient-reported symptoms, and tear breakup time. These findings suggest the treatment positively impacts both objective signs and subjective symptoms of dry eye disease.

In clinical practice, improvements in key measures such as sodium fluorescein corneal staining were observed earlier than traditionally expected. This indicates the potential to monitor patients more frequently soon after treatment initiation to assess both tolerability and effectiveness. Early follow-up allows clinicians to ensure patients are adhering to the regimen and are responding well to the medication, potentially improving overall treatment outcomes.

Overall, the data from the COAT trial support the use of this cyclosporine formulation as a beneficial treatment for dry eye disease, providing improvements across multiple dimensions of ocular health. The ability to detect changes earlier in the treatment course may help optimize patient management by allowing timely adjustments if needed. These insights help refine expectations for treatment onset and reinforce the importance of close clinical monitoring to maximize benefits for patients.