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1) 🇨🇦 The results of Luis Nacul's trial of low-dose naltrexone (LDN) have been published. Unfortunately, it shows that LDN didn't improve fatigue, pain and other symptoms in patients who developed ME/CFS after COVID-19. A brief breakdown of the main results. 👇

2) The trial enrolled 160 participants with what they call "Post-COVID-19 fatigue syndrome (PCFS)." Patients met the 2015 Institute of Medicine ME/CFS criteria, except that symptoms were required to follow COVID-19 and to have lasted at least 3, rather than 6 months.

4) The primary outcome was the Fatigue Severity Scale (FSS) where the score ranges from 0 to 63. The FSS results were basically the same in the LDN and placebo group with a mean difference of only -0.76 points (95% confidence interval -4.18 to 2.67).

5) The trial includes several other outcomes such as pain (VAS), post-exertional malaise (PQSymp-12), quality of life (EQ-5D-5L), activity levels (steps per day measured over 7 days with a pedometer). None of these showed an effect.

6) They also included several physical assessments such as POTS, orthostatic hypotension, handgrip strength and a sit-to-stand test for physical fitness. These showed no significant difference either.