Find us on:

Research

Low Dose Naltrexone in therapy resistant IBD, a case series

Title
Low Dose Naltrexone in therapy resistant IBD, a case series
Publication Type
Abstract/Poster/Letter
Research Type
Human
Reported as
Case Report/Series/Restrospective Study
Date
January 01, 2014
Authors
M. Lie, G. Fuhler, A. de Lima, C. van der Ent, C.J. van der Woude.
Institution
Erasmus Medical Center
Link
Abstract

BACKGROUND: Inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), are chronic relapsing bowel disorders. Several established drug therapies exist, but some patients become resistant to these. For these patients, new treatments are urgently called for. Small studies have suggested that the immune system can be influenced by modulating the opioid receptors in the gut using Low Dose Naltrexone (LDN). Here, we report our experience with LDN in patients resistant to conventional therapies.

METHODS: A case series of all IBD outpatients treated with LDN (5 mg/day) were identified and investigated. Patients with at least 1 follow-up visit were included. Clinical and endoscopic response were analyzed where available. Clinical response was defined as clinical remission after 3 months of treatment. Endoscopic response was defined as a reduction of the endoscopic Mayo score to ≤1.

RESULTS: From June 2010 until June 2013, 40 patients (43% male, median age 40 years, IQR 28–52 years) were treated with LDN. Previous treatments included anti-TNF in 36 patients, immunomodulators in 39 patients and corticosteroids in 40 patients. At time of LDN start, 8 patients were on anti-TNF treatment, 12 received immunomodulators and 18 patients received corticosteroids. Follow-up is ongoing in 27 patients, the other 13 patients were followed for a median of 6 months (IQR 4–13 months). 22 patients had a diagnosis of CD and 18 had UC. Clinical response was achieved in 12 patients (30%), 8 CD (36%) and 4 UC (22%). 22 other patients (55%) had a response of limited duration (1 to 3 months), whereas 6 patients (15%) showed no response at all. Endoscopic data was available in 8 responders, with 7 showing endoscopic response. Endoscopic data of 13 non-responders was available, with none showing endoscopic improvement.

Amongst long term responders, remission was sustained for a median of 21 months (IQR 15–26 months). 9 patients are still in remission, the other 3 patients relapsed at 11, 21 and 21 months. In total, 11 patients underwent surgery (28%), 5 CD (4 subtotal colectomies, 1 partial small bowel resection) and 6 UC patients (all subtotal colectomies). Corticosteroids could be stopped in 13 patients. In total, 5 patients (12%) reported side-effects (headache, nightmares, dizziness), 1 patient stopped LDN treatment because of these.

CONCLUSION: Our data shows that for IBD patients refractory to conventional treatment, LDN may be a promising application - 30% of these severe cases responded to treatment, with 20% of patients showing lasting benefits. The relatively mild side-effects of LDN justify the consideration of this treatment for therapy-resistant IBD or as a bridge to surgery.

cbd oil: cbd and drug testing is cbd different than hemp oil cbd oil for tourettes oranen state regulations for processing hemp cbd oil essential cbd oil is weed legal in the uk cbd clinic revolutionary pain relief pro sport level 5 godesana cbd oil how much cbd isolate to take cbd tulsa oklahoma cbd oil and bodybuilding cbd stricture we sell cbd sign levothyroxine recall 2018 total plant complex cbd oil can cbd oil upset your stomach honest hemp cbd cbd oil hawaii spectrum internet store cbd in kentucky clinical pharmacology best water soluble cbd oil molecular homology definition cbd oil flavoring cbd oil dosing for spondylosis street food sydney cbd

male enhancement: silicone penis extension vardenafil price zynev price generic anxiety meds when does a boys penis stop growing how does flomax work sex online testosterone test online little blue pill for anxiety scalp med price just because ed sex libido erectile dysfunction facts maximum pills erektile dysfunktion otc estrogen supplements penis clamps fda approved over the counter ed pills average sex partners by age 30 easy erection best penis enlarging pills best penis girth best supplements for memory and focus viagra effectiveness male enhancement honey ed combos

weight loss: medi weight loss reviews weight loss alli pills precision weight loss centers green tea with honey for weight loss weight loss challenge 2016 bio x keto pills reviews how does metformin cause weight loss otc diet pills that work fast sauna or steam room for weight loss weight loss on treadmills weight loss calorie calculator goal same and weight loss dr oz weight loss supplement list tnt diet pills weight loss fluctuations weight loss calculator women kayla itsines weight loss jo frost weight loss weight loss pills hypothyroidism gluten free weight loss programs lishou diet pills for sale weight loss tracking chart carb free diets quick weight loss weight loss shakes walmart apidren review pills for weight loss without exercise

vape: vape cloud nano vapor geek vape flask uwell rafale vs tfv4 e cigarettes what miligram of cbd from vape juice is best vapor shop near my location how much nicotine is in 0mg vape juice southside vapor vape juice container ecig tanks 510 how to make cannabis vape oil ecig articles quit smoking by vaping best affordable pen style ecig highest wattage for uwell crown 3 blue dream green house ecig juice vape shops nesr me vaping canabis latest vaping news 2019 beginner box mod abracadabra vape free vapor starter kits squonk mod uwell rafale x rda youtube e cigarette vg liquid