Low-Dose Naltrexone in Rheumatological Diseases (Abstract)

Low-Dose Naltrexone in Rheumatological Diseases

Mediterr J Rheumatol
31 March 2023

Background: Naltrexone has been approved for alcohol and opioid abuse by the FDA. At low-dose naltrexone (LDN) has been used in several diseases including chronic pain and autoimmune conditions, including rheumatic disorders.

Aim: To review the use of LDN in rheumatic diseases: systemic sclerosis (SSc), dermatomyositis (DM), Sjögren's syndrome (SS), rheumatoid arthritis (RA), and fibromyalgia (FM).

Methods: PubMed and Embase databases were searched for articles on LDN and rheumatic diseases between 1966 and August 2022.

Results: Seven studies in FM have been identified: in this disease LDN has showed beneficial effects on pain and well-being. In SS, two articles with 3 cases description showed that LDN may be of help in the pain treatment. LDN relieved pruritus in scleroderma (a case description with a series of 3 patients) and dermatomyositis (description of 3 patients in two articles). In RA a study using Norwegian Prescription Database showed that LDN was associated to reduction in the use of analgesic and DMARDs. No serious side effects were detected.

Conclusion: This review shows that LDN is a promising and safe therapy to be used in some rheumatic disease. However, the data is limited and needs to be reproduced in larger studies.

Keywords: Sjögren’s syndrome; dermatomyositis; fibromyalgia; low-dose naltrexone; naltrexone; opioid system; rheumatic diseases; rheumatoid arthritis.