Weinstock Leonard B, Cottel Jill, Aldridge Lindsey, Egeberg Alexander
Washington University School of Medicine, St. Louis, Missouri.
Herlev and Gentofte Hospital, University of Copenhagen, Denmark.
Int J Pharm Compd. 2020 Mar-Apr;24(2):94-96.
Safe, inexpensive, and convenient psoriasis therapy is desirable. Two recent case reports suggested that low-dose naltrexone is effective. Cases from our practice are presented in order to further the evidence of efficacy and safety of low-dose naltrexone in the treatment of psoriasis. Patients included 13 females, 2 males; mean age 57 years; mean psoriasis duration 16 years. Of the patients, 8 had psoriatic arthritis. In the past, 5 had completely failed and 10 had partially responded to =1 topical therapies. Patients used a self-assessed Likert scale on the effect of low-dose naltrexone on their psoriasis: 1 - worse; 2 - unchanged; 3 - slightly improved; 4 - somewhat improved; 5 - marked improvement. The response to 4.5 mg of oral naltrexone was as follows: 8/15 marked improvement; 2/15 somewhat improved; and 5/15 unchanged. Three adverse events included insomnia, diarrhea, and self-limited headache. Marked improvement was seen by 53% of the 15 patients. Low-dose naltrexone regulates lymphocyte responses, reduces cytokine production, and likely reduces mast cell activity. Low-dose naltrexone is safe, inexpensive, and appears be effective in this open-label study.
安全、廉价且便捷的银屑病治疗方法是人们所期望的。最近的两篇病例报告表明低剂量纳曲酮是有效的。现展示我们诊所的病例，以进一步证明低剂量纳曲酮治疗银屑病的有效性和安全性。患者包括13名女性、2名男性；平均年龄57岁；银屑病平均病程16年。其中8名患者患有银屑病关节炎。过去，5名患者对≥1种局部治疗完全无效，10名患者部分有效。患者使用自我评估的李克特量表来评价低剂量纳曲酮对其银屑病的疗效：1 - 恶化；2 - 无变化；3 - 稍有改善；4 - 有所改善；5 - 显著改善。口服4.5毫克纳曲酮的反应如下：8/15显著改善；2/15有所改善；5/15无变化。3例不良事件包括失眠、腹泻和自限性头痛。15名患者中有53%出现显著改善。低剂量纳曲酮可调节淋巴细胞反应，减少细胞因子生成，并可能降低肥大细胞活性。在这项开放标签研究中，低剂量纳曲酮安全、廉价且似乎有效。
