Clinical Pharmacy, University of Michigan College of Pharmacy, Ann Arbor, Michigan, USA.
University of Michigan Health Department of Pharmacy, Ann Arbor, Michigan, USA.
J Pain Palliat Care Pharmacother. 2024 Mar;38(1):13-19. doi: 10.1080/15360288.2024.2302550. Epub 2024 Feb 1.
Naltrexone is a mu-opioid receptor antagonist increasingly used as an analgesic for chronic pain at low doses. This retrospective, observational cohort study was conducted at an academic medical center to evaluate low-dose naltrexone (LDN) efficacy and describe its use in routine clinical practice. Adults receiving LDN, doses <10 mg for ≥1 month, seen at an outpatient pain clinic from January 1, 2014 to April 1, 2022 were included. The primary outcome was change in the Pain, Enjoyment of Life, and General Activity (PEG) score after LDN. Thirty-one patients were included. Median age was 50 years and 71% were female. Median duration of pain at baseline was 5 years. Mean PEG scores were 7.27 ± 1.39 and 6.62 ± 2.04 at baseline and follow-up, respectively. Mean difference was 0.66 (95% CI [0.10-1.21], = 0.022). Eighty-seven percent (27) of patients discontinued LDN, 52% (16) for lack of benefit, 23% (7) for loss of benefit, 10% (3) for side effects, and 3% (1) for other reasons. Seven (23%) reported side effects. LDN was associated with a statistically significant reduction in PEG in adult chronic pain patients, however the clinical significance is unclear as over 75% of patients discontinued LDN due to lack of benefit.
纳曲酮是一种μ-阿片受体拮抗剂，在低剂量下被越来越多地用作慢性疼痛的镇痛药。这项回顾性、观察性队列研究在一家学术医疗中心进行，旨在评估低剂量纳曲酮（LDN）的疗效，并描述其在常规临床实践中的应用。本研究纳入了 2014 年 1 月 1 日至 2022 年 4 月 1 日期间在门诊疼痛诊所接受 LDN 治疗、剂量<10mg、持续时间≥1 个月的成年人。主要结局是 LDN 治疗后疼痛、享受生活和一般活动（PEG）评分的变化。共纳入 31 名患者。患者中位年龄为 50 岁，71%为女性。基线时疼痛持续时间中位数为 5 年。PEG 评分的平均值分别为基线时的 7.27±1.39 和随访时的 6.62±2.04。平均差值为 0.66（95%CI[0.10-1.21]，P=0.022）。87%（27）的患者停用了 LDN，52%（16）的患者因缺乏疗效，23%（7）的患者因疗效丧失，10%（3）的患者因副作用，3%（1）的患者因其他原因。7（23%）名患者报告有副作用。LDN 与成年慢性疼痛患者 PEG 评分的统计学显著降低相关，但由于超过 75%的患者因缺乏疗效而停用 LDN，其临床意义尚不清楚。
