Disclosures: Arman A. Jahangiri, BS: No financial relationships or conflicts of interest

Objective: The goals of this study were: (1) to identify if the median Low-Dose Naltrexone (LDN) therapeutic duration and dosage were different between Fibromyalgia (FM), Chronic Pain Syndrome (CPS), or Multiple Sclerosis (MS) patients, and (2) to determine which disease group had an improvement in quality of life (QOL) and pain alleviation.

Design: Retrospective chart reviewSetting : 2 Oregon Pharmacy DatabasesParticipants : 45 patients were included and reviewed: 15 FM, 15 CPS, and 15 MS.

Interventions: Not applicable.

Main Outcome Measures: Primary outcomes were median duration (in months) of LDN use and LDN dosage (mg/day) and were compared using Mood’s Median Test. Descriptive analyses of pain scores, subjective pain, and QOL changes were captured at first follow-up appointment and last appointment in the medical records.

Results: MS and FM patients had significantly higher start doses (4.5mg/day) compared to CPS (3.0mg/day) (p < 0.013). MS patients had the longest duration on LDN therapy between the initial appointment when treatment began and the last documented appointment (42.0 [23.68, 58.57] vs. CPS (4.0 [3.11, 7.28]) vs. FM (3.0 [2.45, 12.20]), (p < 0.001). Among those with documented pain scores, 85.3% of FM and CPS patients improved or stayed the same between the first follow-up and last appointments. Patients reported energy improvement (46.2%), sleep improvement (23.1%), and mood improvement (30.8%). Overall, pain alleviation and QOL improvements were greatest for FM and MS patients on LDN therapy, respectively.Conclusions: When retrospectively analyzing LDN therapy as a safe and effective alternative for chronic pain treatment and QOL improvement, our data contributes to the ongoing clinical evidence of efficacy with FM, MS, and CPS patients. Future research should continue to focus on LDN as an off-label, non-opioid analgesic for pain, anti-inflammatory, and disease modification for these chronic conditions. Furthermore, proper dosing studies need to be performed to investigate the true therapeutic range and process in determining an individual's optimal dosage.

Level of Evidence: Level III

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/the-efficacy-of-low-dose-naltrexone-as-a-therapeutic-alternative-for-fibromyalgia-chronic-pain-syndrome-and-multiple-sclerosis-a-retrospective-chart-review/