Is low dose naltrexone effective

Cochrane

What is Crohn's Disease?

Crohn's disease (Crohn's disease) is a chronic inflammatory disease of the bowel that can affect people anywhere from the mouth to the anus. Common symptoms are stomach pain, diarrhea, and weight loss. People with Crohn's disease who have symptoms have an “active” disease. When the symptoms subside, it is called “remission”.

What is naltrexone?

Naltrexone is a long-acting opioid antagonist. It is a drug that counteracts the effects of opiates. This drug is commonly used to treat alcohol and opioid abuse and is taken orally. Certain hormones (proteins that carry instructions in the body) that are known to be involved in the pain response may also be involved in the inflammation that causes Crohn's disease. Taking a low dose of naltrexone may improve Crohn's disease.

What did the authors examine?

Researchers examined the effectiveness and safety (i.e., side effects) of low-dose naltrexone therapy for inducing remission in people with active Crohn's disease.

What did the authors find out?

This review identified two small randomized controlled trials that enrolled a total of 46 participants. One study compared 12 weeks of low-dose naltrexone (4.5 mg / day) to placebo (a dummy drug such as a sugar pill) in 34 adult patients with active Crohn's disease. The other study compared 8 weeks of treatment with low dose naltrexone (0.1 mg / kg up to a maximum of 4.5 mg / day) with placebo in 12 children with active Crohn's disease. The results of both studies were not precise enough about the proportion of patients who achieved clinical remission. The results of the adult patient study suggest that low-dose naltrexone may have a benefit in terms of clinical response (i.e., improvement in disease symptoms) and endoscopic response (i.e., a decrease in inflammation of the bowel, as demonstrated by examining the bowel with an endoscope). We cannot say whether low-dose naltrexone caused certain side effects such as difficulty sleeping, unusual dreams, headache, loss of appetite, nausea, and fatigue, as only a small number of people in the studies had such problems. The results of this review should be interpreted with caution as they are based on a small number of patients and the overall quality of the evidence has been rated as low due to insufficient precision of the results. Therefore, no firm conclusions can be drawn regarding the efficacy and side effect profile of low-dose naltrexone as a treatment for patients with active Crohn's disease. Further randomized controlled trials are needed to assess the effectiveness and side effects of low dose naltrexone as therapy in adults and children with active Crohn's disease.