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The Safety and Efficacy of Low-Dose Naltrexone in Patients with Fibromyalgia: A Systematic Review

Fibromyalgia (FM) is a chronic pain sensitivity syndrome characterized by diffuse musculoskeletal pain and many other systemic manifestations. Low-dose naltrexone (LDN) has been increasingly used as an off-label treatment option in FM. However, current evidence on the safety and efficacy of LDN in p...

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Autores principales: Yang, Juan, Shin, Kyung-Min, Do, Alex, Bierle, Dennis M, Abu Dabrh, Abd Moain, Yin, Ziying, Bauer, Brent A, Mohabbat, Arya B
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10039621/
https://www.ncbi.nlm.nih.gov/pubmed/36974308
http://dx.doi.org/10.2147/JPR.S395457
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author Yang, Juan
Shin, Kyung-Min
Do, Alex
Bierle, Dennis M
Abu Dabrh, Abd Moain
Yin, Ziying
Bauer, Brent A
Mohabbat, Arya B
author_facet Yang, Juan
Shin, Kyung-Min
Do, Alex
Bierle, Dennis M
Abu Dabrh, Abd Moain
Yin, Ziying
Bauer, Brent A
Mohabbat, Arya B
author_sort Yang, Juan
collection PubMed
description Fibromyalgia (FM) is a chronic pain sensitivity syndrome characterized by diffuse musculoskeletal pain and many other systemic manifestations. Low-dose naltrexone (LDN) has been increasingly used as an off-label treatment option in FM. However, current evidence on the safety and efficacy of LDN in patients with FM is not well known. To systematically assess the current evidence on the safety and efficacy of LDN use in the treatment of FM. A comprehensive bibliographic search was conducted on EBM Reviews – Cochrane Central Register of Controlled Trials, EBM Reviews – Cochrane Database of Systematic, Embase, Ovid MEDLINE(R) and Epub Ahead of Print, In-Process, In-Data-Review & Other Non-Indexed Citations, Daily and Versions and Scopus databases in September 2022. Inclusion criteria were articles that were published in English, focusing on clinical trials involving LDN for the treatment of FM. Two reviewers independently screened and extracted the data. A qualitative analysis was used due to the high methodological heterogeneity between studies. The electronic search produced 805 articles. After applying the inclusion criteria, 9 articles (one RCT, two case reports, two case series, and four pilot trials) were selected for evaluation. LDN intervention protocols, study designs, and follow-up periods were different among the included studies. Overall, LDN was found to be effective in the symptomatic management of FM, and of the 78% of included studies that evaluated for safety, no severe adverse events were reported. Proving the efficacy and safety of low-dose naltrexone is a future possibility based on current study data, but the level of scientific evidence is limited. Future well-designed trials with large sample sizes are required.
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spelling pubmed-100396212023-03-26 The Safety and Efficacy of Low-Dose Naltrexone in Patients with Fibromyalgia: A Systematic Review Yang, Juan Shin, Kyung-Min Do, Alex Bierle, Dennis M Abu Dabrh, Abd Moain Yin, Ziying Bauer, Brent A Mohabbat, Arya B J Pain Res Review Fibromyalgia (FM) is a chronic pain sensitivity syndrome characterized by diffuse musculoskeletal pain and many other systemic manifestations. Low-dose naltrexone (LDN) has been increasingly used as an off-label treatment option in FM. However, current evidence on the safety and efficacy of LDN in patients with FM is not well known. To systematically assess the current evidence on the safety and efficacy of LDN use in the treatment of FM. A comprehensive bibliographic search was conducted on EBM Reviews – Cochrane Central Register of Controlled Trials, EBM Reviews – Cochrane Database of Systematic, Embase, Ovid MEDLINE(R) and Epub Ahead of Print, In-Process, In-Data-Review & Other Non-Indexed Citations, Daily and Versions and Scopus databases in September 2022. Inclusion criteria were articles that were published in English, focusing on clinical trials involving LDN for the treatment of FM. Two reviewers independently screened and extracted the data. A qualitative analysis was used due to the high methodological heterogeneity between studies. The electronic search produced 805 articles. After applying the inclusion criteria, 9 articles (one RCT, two case reports, two case series, and four pilot trials) were selected for evaluation. LDN intervention protocols, study designs, and follow-up periods were different among the included studies. Overall, LDN was found to be effective in the symptomatic management of FM, and of the 78% of included studies that evaluated for safety, no severe adverse events were reported. Proving the efficacy and safety of low-dose naltrexone is a future possibility based on current study data, but the level of scientific evidence is limited. Future well-designed trials with large sample sizes are required. Dove 2023-03-21 /pmc/articles/PMC10039621/ /pubmed/36974308 http://dx.doi.org/10.2147/JPR.S395457 Text en © 2023 Yang et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Review
Yang, Juan
Shin, Kyung-Min
Do, Alex
Bierle, Dennis M
Abu Dabrh, Abd Moain
Yin, Ziying
Bauer, Brent A
Mohabbat, Arya B
The Safety and Efficacy of Low-Dose Naltrexone in Patients with Fibromyalgia: A Systematic Review
title The Safety and Efficacy of Low-Dose Naltrexone in Patients with Fibromyalgia: A Systematic Review
title_full The Safety and Efficacy of Low-Dose Naltrexone in Patients with Fibromyalgia: A Systematic Review
title_fullStr The Safety and Efficacy of Low-Dose Naltrexone in Patients with Fibromyalgia: A Systematic Review
title_full_unstemmed The Safety and Efficacy of Low-Dose Naltrexone in Patients with Fibromyalgia: A Systematic Review
title_short The Safety and Efficacy of Low-Dose Naltrexone in Patients with Fibromyalgia: A Systematic Review
title_sort safety and efficacy of low-dose naltrexone in patients with fibromyalgia: a systematic review
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10039621/
https://www.ncbi.nlm.nih.gov/pubmed/36974308
http://dx.doi.org/10.2147/JPR.S395457
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