Peters 2022: low-dose naltrexone didn't help quality of life in brain tumours

What they tested

People with high-grade glioma were randomly assigned to low-dose naltrexone 4.5 mg by mouth at night (54 people) or a placebo (56 people). They started on the first day of radiation and temozolomide chemotherapy and continued for 16 weeks. Neither patients nor staff knew who got which.

The researchers measured changes in quality of life and fatigue with patient questionnaires (FACT-Brain and FACIT-Fatigue). The idea came from reports that low-dose naltrexone improved quality of life and fatigue in other neurological illnesses, such as multiple sclerosis.

What they found

Changes in quality of life and fatigue from the start to the end of chemotherapy and radiation were not significantly different between low-dose naltrexone and placebo.

Side effects looked alike in both groups and were attributed to temozolomide. Most participants had grade IV tumours (85%), 56% were men and their average age was 56.

Limits

• It included only people with high-grade glioma during chemotherapy and radiation, so it can't speak to other conditions.
• Outcomes were reported for the period of chemotherapy and radiation, not for longer-term use.

What it means if you're considering naltrexone

Low-dose naltrexone is compounded and used off-label for many conditions. In this placebo-controlled trial in people with brain tumours, it made no difference to quality of life or fatigue.