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Review
. 2023 Mar 31;34(1):1-6.
doi: 10.31138/mjr.34.1.1. eCollection 2023 Mar.

Low-Dose Naltrexone in Rheumatological Diseases

Jozélio Freire de Carvalho  1 , Thelma Skare  2
Affiliations
Review

Low-Dose Naltrexone in Rheumatological Diseases

Jozélio Freire de Carvalho et al. Mediterr J Rheumatol. .

Abstract

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.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1.
Figure 1.
Flowchart of the studies on LDN and rheumatic diseases.
See this image and copyright information in PMC

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