Trial Report Low-dose naltrexone and NAD+ for the treatment of patients with persistent fatigue symptoms after COVID-19, 2024, Isman

https://www.sciencedirect.com/science/article/pii/S2666354624000115

Brain, Behavior, & Immunity - Health
Volume 36, March 2024, 100733

Low-dose naltrexone and NAD+ for the treatment of patients with persistent fatigue symptoms after COVID-19
Anar Isman a, Andy Nyquist a,*, Bailey Strecker a, Girish Harinath a, Virginia Lee a,
Xingyu Zhang b, Sajad Zalzala
a
AgelessRx, 2370 E Stadium Blvd #2049, Ann Arbor, MI, 48104, USA
b
Thomas E. Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, PA, 15213, USA
Received 31 July 2023, Revised 15 December 2023, Accepted 25 January 2024, Available online 1 February 2024, Version of Record 6 February 2024.



https://doi.org/10.1016/j.bbih.2024.100733Get rights and content

open access

Highlights

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  A subset of patients experienced persistent fatigue symptoms after COVID-19.
  
  
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  Treatment with low-dose naltrexone (LDN) and NAD+ was well tolerated.
  
  
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  Treatment increased SF-36 quality of life scores.
  
  
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  Treatment also improved fatigue symptom scores.
  
  
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  A subset of patients were clinically responsive.
  

Abstract

A subset of patients experiences persistent fatigue symptoms after COVID-19, and patients may develop long COVID, which is characterized by lasting systemic symptoms.

No treatments for this condition have been validated and are urgently warranted.

In this pilot study, we assessed whether treatment with low-dose naltrexone (LDN, 4.5 mg/day) and supplementation with NAD + through iontophoresis patches could improve fatigue symptoms and quality of life in 36 patients with persistent moderate/severe fatigue after COVID-19.

We detected a significant increase from baseline in SF-36 survey scores after 12 weeks of treatment (mean total SF-36 score 36.5 [SD: 15.6] vs. 52.1 [24.8]; p < 0.0001), suggestive of improvement of quality of life.

Furthermore, participants scored significantly lower on the Chalder fatigue scale after 12 weeks of treatment (baseline: 25.9 [4.6], 12 weeks: 17.4 [9.7]; p < 0.0001).

We found a subset of 52 % of patients to be responders after 12 weeks of treatment.

Treatment was generally safe, with mild adverse events previously reported for LDN, which could be managed with dose adjustments.

The iontophoresis patches were associated with mild, short-lived skin irritation in 25 % of patients.

Our data suggest treatment with LDN and NAD+ is safe and may be beneficial in a subset of patients with persistent fatigue after COVID-19.

Larger randomized controlled trials will have to confirm our data and determine which patient subpopulations might benefit most from this strategy.

 

Open label, uncontrolled.

Subjective outcome reporting.