One medication that currently is
not approved for treatment in Crohn’s is low dose naltrexone (also known as
LDN). People have claimed it can help patients with Crohn’s. Others say it is
wishful thinking. I like to evaluate things based off evidence and facts and
from what I have seen LDN seems like it could be another tool doctor’s use in
the battle against Crohn’s.
Dr. Jill Smith professor of gastroenterology
at Penn State University’s College of Medicine has done some studies looking at
the effectiveness of LDN. One study in the April 2007 American Journal of Gastroenterology found that 67% of patients who
took LDN went into remission. What is
even more remarkable is that 89% of patients had some type of response to the
treatment. These results were statistically significant meaning they were not
due to just chance alone. There was also endoscopic evidence meaning when a colonoscopy
was performed there was less inflammation and mucosal healing.
In another study published in 2011
entitled “Therapy with the opioid antagonist naltrexone promotes mucosal
healing in active Crohn's disease: a randomized placebo-controlled trial” Dr. Smith
and her colleagues found that 88% of those treated with LDN saw a drop in their
CDAI scores. Also after 3 months, 78% of patients had endoscopic evidence
showing improvement. Fatigue was the only side effect reported. Over half the patients
who failed or couldn’t handle biologics were enrolled in this study.
Naltrexone itself has been around
since 1992 when it was used for people who were alcohol dependent. It is
important to point out that people who take naltrexone for alcohol dependence take
a much higher dose (100mg) as opposed to low dose naltreone which is only 4.5
mg. The side effects of LDN should be much less than the regular version. It would be interesting to see if increasing
the LDN higher would create even better results in patients.
The data is in and it looks like
LDN could provide help for Crohn’s patients. Although, more studies and long
term safety data have to be evaluated naltrexone can be prescribed however this
is considered an “off-label use”. Dr. Jill Smith and a colleague have the
patent for naltrexone in people who have inflammatory bowel disease. Remember
just because a drug gets approved doesn’t mean it is approved for all illnesses
and diseases. If a drug is safe and has
been around for two decades why on earth are people not allowed to take LDN?
My own view is that once the FDA
deems a drug safe (Phase I) people should be allowed to take it to determine
the drug’s effectiveness. Millions of people are suffering in pain because the
FDA won’t let them consume drugs that could help. Everyone has different body chemistry and
reacts differently. I would rather have this then the FDA make blanket
statements saying this group or that group can’t consume a drug.
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