LDN in Rheumatoid and Seropositive Arthritis

While studies indicate beneficial effects of LDN in autoimmune diseases, clinical research on LDN in rheumatic disease is limited. Using a pharmaco-epidemiological approach, Norwegian researchers tested the hypothesis that LDN use leads to reduced dispensing of other drugs (NSAIDs, opioids, TNF-α antagonists and DMARDs) used in the treatment of rheumatic disease. Patients (n = 360) were stratified into three groups based on LDN exposure. In persistent LDN users, there was a 13% relative reduction in cumulative defined daily doses (DDD) of all medicines examined and 23% reduction of analgesics. There was no significant DDD change in patients with less LDN exposure. There was a decrease in the number of NSAID users among patients with the least LDN exposure. The results support the hypothesis that persistent use of LDN reduces the need for other medications used in the treatment of rheumatic and seropositive arthritis. Randomized clinical trials of LDN in rheumatic disease are warranted.

PLoS One. 2019 Feb 14;14(2):e0212460.

Low dose naltrexone: Effects on medication in rheumatoid and seropositive arthritis. A nationwide register-based controlled quasi-experimental before-after study

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Treatment of Autoimmune Disease with LDN

Zagon and McLaughlin of the Department of Neural and Behavioral Sciences, Penn State University College of Medicine, explained the intermittent blockade of the opioid growth factor (OGF) – OGF receptor (OGFr) axis by low dose naltrexone (LDN), and the role of enkephalin (i.e., OGF) in autoimmune disorders, specifically multiple sclerosis, Crohn’s disease, and fibromyalgia. “Clinical reports on subjects taking LDN have documented reduced fatigue, few side-effects, and improved overall health… Intermittent OGFr blockade with LDN restores serum enkephalin levels… The interplay between LDN, and the onset and treatment of autoimmune diseases, chronic pain, and other addictive behaviors requires further investigation, but highlights a central role for enkephalins and intermittent blockade of the OGF-OGFr pathway in pathogenesis and treatment of these disorders.”

Exp Biol Med (Maywood). 2018 Dec;243(17-18):1323-1330.

Intermittent blockade of OGFr and treatment of autoimmune disorders

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LDN for Multiple Sclerosis

The review focused on 215 MS patients who were provided a prescription for oral LDN. The study reports that a significant number of patients found combination therapy of an immunomodulating agent and LDN to be tolerable and possibly beneficial. Some patients preferred LDN alone. LDN did not cause any unexpected side effects.

J Clin Psychopharmacol. 2015 Oct;35(5):609-11.

Low Dose Naltrexone for Treatment of Multiple Sclerosis: A Retrospective Chart Review of Safety and Tolerability

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Clinical Benefits of Low-Dose Naltrexone for Sjogren’s

Sjogren’s Syndrome is a chronic autoimmune disorder that causes inflammation of the lacrimal and salivary glands, resulting in dryness of the eyes and mouth. In addition, fatigue and musculoskeletal pain, often described as aching, is very common. Treatment directed toward alleviating the fatigue and pain associated with Sjogren’s is currently very limited. Since Low-Dose Naltrexone (LDN) has pain-relieving and anti-inflammatory properties, case reports on patients with suspected Sjogren’s based on long-standing dry eyes, dry mouth, joint pain, fatigue and elevated measures of inflammation showed clinical improvement with LDN.

Cureus. 2019 Mar 11;11(3):e4225.

Sjogren’s Syndrome: Clinical Benefits of Low-dose Naltrexone Therapy

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Cureus. 2020 Jul 1;12(7):e8948.

Sjogren’s Syndrome and Clinical Benefits of Low-Dose Naltrexone Therapy: Additional Case Reports

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