Thursday 13 May 2010

Revolution Health Users Give Top Marks to Low Dose Naltrexone (LDN) for Crohn's Disease


Abstract of Phase II Trial Results for Low Dose Naltrexone (LDN) for Crohn's Disease from Dr Jill Smith, Penn State University

Abstract Link

This is a highly significant result for Low Dose Naltrexone as it's a Phase II study which was carried out under randomised, double-blind, placebo-controlled conditions.

Summary -

45% of 40 patients achieved remission inside 12 weeks.
(Note, clinical experience shows it can take more than 3 months to really get results with LDN and certainly 4.5mg is often too high a dose too).

82% of the 40 patients had their Crohn's improve by around 20% or more in terms of its activity.
Healing was reported in the endoscopy studies too.

Although this is not quite as impressive a result as the first study, it is at least as good as many other treatments and with a lot, lot less side effects (Only reversible liver enzyme changes reported).

For comparison, this anti-TNF treatment managed 40% remission after 5 years, chances are LDN could be 5%+ better than that :

http://www.medpagetoday.com/MeetingCoverage/DDW/19885

Remicade + azathioprine managed roughly 50% remission after 26 weeks, but that is of course at a big price financially and in terms of side-effects -

http://www.webmd.com/ibd-crohns-disease/crohns-disease/news/20100414/combination-therapy-treats-crohns-disease

Obviously a Phase III study will be interesting now as it will have a much bigger patient population and maybe run longer too.
Would be interesting to see how the remission rate is after another 3 months.
Would be even more interesting to see how it was if the patients were allowed to decrease dose too.

Note that Dr Smith has another study starting on Vitamin D with Crohn's too.