{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T19:06:14Z","timestamp":1784055974583,"version":"3.55.0"},"reference-count":73,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2022,1,6]],"date-time":"2022-01-06T00:00:00Z","timestamp":1641427200000},"content-version":"unspecified","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002809","name":"Generalitat de Catalunya","doi-asserted-by":"publisher","award":["UAB-LE-8015"],"award-info":[{"award-number":["UAB-LE-8015"]}],"id":[{"id":"10.13039\/501100002809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["CPII19\/00003"],"award-info":[{"award-number":["CPII19\/00003"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["FI20\/00034"],"award-info":[{"award-number":["FI20\/00034"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["ICI20\/00080"],"award-info":[{"award-number":["ICI20\/00080"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003030","name":"Ag\u00e8ncia de Gesti\u00f3 d'Ajuts Universitaris i de Recerca","doi-asserted-by":"crossref","award":["FI_B\/00216"],"award-info":[{"award-number":["FI_B\/00216"]}],"id":[{"id":"10.13039\/501100003030","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2021,12,3]]},"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>There is evidence that low-dose naltrexone (LDN; &lt;5.0\u2009mg\/day) reduces pain and improves the quality of life of people with fibromyalgia syndrome (FMS). However, no randomised controlled trials with long-term follow-ups have been carried out. The INNOVA study will evaluate the add-on efficacy, safety, cost\u2013utility and neurobiological effects of LDN for reducing pain in patients with FMS, with a 1-year follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>A single-site, prospective, randomised, double-blinded, placebo-controlled, parallel design phase III trial will be performed. Eligibility criteria include being adult, having a diagnosis of FMS and experiencing pain of 4 or higher on a 10-point numerical rating scale. Participants will be randomised to a LDN intervention group (4.5\u2009mg\/day) or to a placebo control group. Clinical assessments will be performed at baseline (T0), 3\u2009months (T1), 6\u2009months (T2) and 12\u2009months (T3). The primary endpoint will be pain intensity. A sample size of 60 patients per study arm (120 in total), as calculated prior to recruitment for sufficient power, will be monitored between January 2022 and August 2024. Assessment will also include daily ecological momentary evaluations of FMS-related symptoms (eg, pain intensity, fatigue and sleep disturbance), and side effects via ecological momentary assessment through the Pain Monitor app during the first 3\u2009months. Costs and quality-adjusted life years will be also calculated. Half of the participants in each arm will be scanned with MRI at T0 and T1 for changes in brain metabolites related to neuroinflammation and central sensitisation. Inflammatory biomarkers in serum will also be measured.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>This study has been approved by the Ethics Committee of the Fundaci\u00f3 Sant Joan de D\u00e9u. The results will be actively disseminated through peer-reviewed journals, conference presentations, social media and community engagement activities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT04739995\">NCT04739995<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2021-055351","type":"journal-article","created":{"date-parts":[[2022,1,6]],"date-time":"2022-01-06T11:43:18Z","timestamp":1641469398000},"page":"e055351","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":14,"title":["Study protocol for a randomised, double-blinded, placebo-controlled phase III trial examining the add-on efficacy, cost\u2013utility and neurobiological effects of low-dose naltrexone (LDN) in patients with fibromyalgia (INNOVA study)"],"prefix":"10.1136","volume":"12","clinical-trial-number":[{"clinical-trial-number":"nct04739995","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Ariadna","family":"Colomer-Carbonell","sequence":"first","affiliation":[{"name":"Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de D\u00e9u, St. Boi de Llobregat, Spain"},{"name":"Department of Basics, Developmental and Educational Psychology, Autonomous University of Barcelona, Cerdanyola del Vall\u00e8s, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan P","family":"Sanabria-Mazo","sequence":"additional","affiliation":[{"name":"Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de D\u00e9u, St. Boi de Llobregat, Spain"},{"name":"Department of Basics, Developmental and Educational Psychology, Autonomous University of Barcelona, Cerdanyola del Vall\u00e8s, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Halbert","family":"Hern\u00e1ndez-Negr\u00edn","sequence":"additional","affiliation":[{"name":"Department of Basics, Developmental and Educational Psychology, Autonomous University of Barcelona, Cerdanyola del Vall\u00e8s, Spain"},{"name":"Universidad de Ciencias M\u00e9dicas de Villa Clara, Santa Clara, Cuba"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3972-1385","authenticated-orcid":false,"given":"Xavier","family":"Borr\u00e0s","sequence":"additional","affiliation":[{"name":"Department of Basics, Developmental and Educational Psychology, Autonomous University of Barcelona, Cerdanyola del Vall\u00e8s, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Suso-Ribera","sequence":"additional","affiliation":[{"name":"Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I, Castello de la Plana, Spain"},{"name":"Biomedical Research Centre in Physiopathology of Obesity and Nutrition (CIBERobn), Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Azucena","family":"Garc\u00eda-Palacios","sequence":"additional","affiliation":[{"name":"Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I, Castello de la Plana, Spain"},{"name":"Biomedical Research Centre in Physiopathology of Obesity and Nutrition (CIBERobn), Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordi","family":"Muchart","sequence":"additional","affiliation":[{"name":"Diagnostic Imaging Department, Hospital Sant Joan de D\u00e9u, Esplugues de Llobregat, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josep","family":"Munuera","sequence":"additional","affiliation":[{"name":"Diagnostic Imaging Department, Hospital Sant Joan de D\u00e9u, Esplugues de Llobregat, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"D'Amico","sequence":"additional","affiliation":[{"name":"Personal Social Services Research Unit, London School of Economics and Political Science, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Maes","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Chulalongkorn University, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jarred W","family":"Younger","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham, Birmingham, Alabama, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert","family":"Feliu-Soler","sequence":"additional","affiliation":[{"name":"Department of Clinical and Health Psychology, Autonomous University of Barcelona, Cerdanyola del Vall\u00e8s, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoni","family":"Rozadilla-Sacanell","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Parc Sanitari Sant Joan de D\u00e9u, St. Boi de Llobregat, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0750-1599","authenticated-orcid":false,"given":"Juan V","family":"Luciano","sequence":"additional","affiliation":[{"name":"Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de D\u00e9u, St. Boi de Llobregat, Spain"},{"name":"Department of Clinical and Health Psychology, Autonomous University of Barcelona, Cerdanyola del Vall\u00e8s, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,1,6]]},"reference":[{"key":"2025120523473305000_12.1.e055351.1","doi-asserted-by":"crossref","DOI":"10.1038\/nrdp.2015.22","article-title":"Fibromyalgia","volume":"1","author":"H\u00e4user","year":"2015","journal-title":"Nat Rev Dis Primers"},{"key":"2025120523473305000_12.1.e055351.2","first-page":"88","article-title":"Fibromyalgia and psychiatric disorders","volume":"78","author":"Fietta","year":"2007","journal-title":"Acta Biomed"},{"key":"2025120523473305000_12.1.e055351.3","doi-asserted-by":"publisher","DOI":"10.1007\/s11916-013-0356-5"},{"key":"2025120523473305000_12.1.e055351.4","first-page":"16","article-title":"Drugs to treat fibromyalgia - the transatlantic difference","volume":"11","author":"Briley","year":"2010","journal-title":"Curr Opin Investig Drugs"},{"key":"2025120523473305000_12.1.e055351.5","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2011-201249"},{"key":"2025120523473305000_12.1.e055351.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2016.12.006"},{"key":"2025120523473305000_12.1.e055351.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2014.01.001"},{"key":"2025120523473305000_12.1.e055351.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2010.09.030"},{"key":"2025120523473305000_12.1.e055351.9","doi-asserted-by":"publisher","DOI":"10.1002\/art.27497"},{"key":"2025120523473305000_12.1.e055351.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.neulet.2012.03.010"},{"key":"2025120523473305000_12.1.e055351.11","doi-asserted-by":"crossref","first-page":"2248","DOI":"10.1097\/j.pain.0000000000000634","article-title":"Combined glutamate and glutamine levels in pain-processing brain regions are associated with individual pain sensitivity","volume":"157","author":"Zunhammer","year":"2016","journal-title":"Pain"},{"key":"2025120523473305000_12.1.e055351.12","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0000000000000474"},{"key":"2025120523473305000_12.1.e055351.13","doi-asserted-by":"publisher","DOI":"10.1186\/s13075-014-0425-0"},{"key":"2025120523473305000_12.1.e055351.14","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.2011.01820.x"},{"key":"2025120523473305000_12.1.e055351.15","doi-asserted-by":"crossref","DOI":"10.1186\/ar3072","article-title":"Localized 1H-NMR spectroscopy in patients with fibromyalgia: a controlled study of changes in cerebral glutamate\/glutamine, inositol, choline, and N-acetylaspartate","volume":"12","author":"Fayed","year":"2010","journal-title":"Arthritis Res Ther"},{"key":"2025120523473305000_12.1.e055351.16","doi-asserted-by":"publisher","DOI":"10.1002\/art.24849"},{"key":"2025120523473305000_12.1.e055351.17","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A2550"},{"key":"2025120523473305000_12.1.e055351.18","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000000017"},{"key":"2025120523473305000_12.1.e055351.19","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1016\/j.medcli.2017.01.034","article-title":"Cerebral magnetic resonance changes associated with fibromyalgia syndrome","volume":"148","author":"Murga","year":"2017","journal-title":"Med Clin"},{"key":"2025120523473305000_12.1.e055351.20","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-140-8-200404200-00010"},{"key":"2025120523473305000_12.1.e055351.21","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2013.06.022"},{"key":"2025120523473305000_12.1.e055351.22","doi-asserted-by":"publisher","DOI":"10.1007\/s12035-009-8077-9"},{"key":"2025120523473305000_12.1.e055351.23","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbi.2006.10.011"},{"key":"2025120523473305000_12.1.e055351.24","doi-asserted-by":"publisher","DOI":"10.1152\/physrev.00011.2010"},{"key":"2025120523473305000_12.1.e055351.25","doi-asserted-by":"publisher","DOI":"10.1016\/j.iac.2009.02.002"},{"key":"2025120523473305000_12.1.e055351.26","doi-asserted-by":"publisher","DOI":"10.1038\/npp.2016.199"},{"key":"2025120523473305000_12.1.e055351.27","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbi.2018.09.018"},{"key":"2025120523473305000_12.1.e055351.28","doi-asserted-by":"publisher","DOI":"10.1038\/npp.2016.185"},{"key":"2025120523473305000_12.1.e055351.29","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbi.2019.12.02"},{"key":"2025120523473305000_12.1.e055351.30","doi-asserted-by":"publisher","DOI":"10.2147\/JPR.S128508"},{"key":"2025120523473305000_12.1.e055351.31","doi-asserted-by":"publisher","DOI":"10.1016\/j.coph.2011.10.007"},{"key":"2025120523473305000_12.1.e055351.32","doi-asserted-by":"publisher","DOI":"10.1002\/da.22084"},{"key":"2025120523473305000_12.1.e055351.33","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-014-2517-2"},{"key":"2025120523473305000_12.1.e055351.34","doi-asserted-by":"publisher","DOI":"10.1002\/phar.2086"},{"key":"2025120523473305000_12.1.e055351.35","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1111\/j.1526-4637.2009.00613.x","article-title":"Fibromyalgia symptoms are reduced by low-dose naltrexone: a pilot study","volume":"10","author":"Younger","year":"2009","journal-title":"Pain Med"},{"key":"2025120523473305000_12.1.e055351.36","doi-asserted-by":"publisher","DOI":"10.1002\/art.37734"},{"key":"2025120523473305000_12.1.e055351.37","doi-asserted-by":"crossref","DOI":"10.3390\/biomedicines5020016","article-title":"Reduced pro-inflammatory cytokines after eight weeks of low-dose naltrexone for fibromyalgia","volume":"5","author":"Parkitny","year":"2017","journal-title":"Biomedicines"},{"key":"2025120523473305000_12.1.e055351.38","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-158-3-201302050-00583"},{"key":"2025120523473305000_12.1.e055351.39","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.c332"},{"key":"2025120523473305000_12.1.e055351.40","doi-asserted-by":"publisher","DOI":"10.1186\/1741-7015-11-80"},{"key":"2025120523473305000_12.1.e055351.41","doi-asserted-by":"crossref","first-page":"999","DOI":"10.1111\/cns.12314","article-title":"Changes in metabolites after treatment with memantine in fibromyalgia. A double-blind randomized controlled trial with magnetic resonance spectroscopy with a 6-month follow-up","volume":"20","author":"Fayed","year":"2014","journal-title":"CNS Neurosci Ther"},{"key":"2025120523473305000_12.1.e055351.42","doi-asserted-by":"crossref","DOI":"10.3390\/jcm9041219","article-title":"Diagnostic criteria for fibromyalgia: critical review and future perspectives","volume":"9","author":"Galvez-S\u00e1nchez","year":"2020","journal-title":"J Clin Med"},{"key":"2025120523473305000_12.1.e055351.43","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0037504"},{"key":"2025120523473305000_12.1.e055351.44","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-014-3074-3"},{"key":"2025120523473305000_12.1.e055351.45","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2007.09.005"},{"key":"2025120523473305000_12.1.e055351.46","doi-asserted-by":"publisher","DOI":"10.1186\/ar2783"},{"key":"2025120523473305000_12.1.e055351.47","doi-asserted-by":"crossref","first-page":"1682","DOI":"10.1002\/acr.22034","article-title":"Dimensionality, reliability, and validity of the revised fibromyalgia impact questionnaire in two Spanish samples","volume":"65","author":"Luciano","year":"2013","journal-title":"Arthritis Care Res"},{"key":"2025120523473305000_12.1.e055351.48","doi-asserted-by":"publisher","DOI":"10.1016\/0005-7967(94)00075-U"},{"key":"2025120523473305000_12.1.e055351.49","first-page":"S70","article-title":"Relationship of severity of depression, anxiety and stress with severity of fibromyalgia","volume":"29","author":"Alok","year":"2011","journal-title":"Clin Exp Rheumatol"},{"key":"2025120523473305000_12.1.e055351.50","first-page":"679","article-title":"Psychometric properties of the Spanish version of depression, anxiety and stress scales (DASS)","volume":"17","author":"Bados","year":"2005","journal-title":"Psicothema"},{"key":"2025120523473305000_12.1.e055351.51","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1016\/j.jpain.2015.02.008","article-title":"Development and initial validation of a brief self-report measure of cognitive dysfunction in fibromyalgia","volume":"16","author":"Kratz","year":"2015","journal-title":"J Pain"},{"key":"2025120523473305000_12.1.e055351.52","doi-asserted-by":"crossref","DOI":"10.1111\/jabr.12134","article-title":"Digging into the construct of fibrofog: psychometric properties of the Spanish version of the multidimensional inventory of subjective cognitive impairment in patients with fibromyalgia","volume":"23","author":"Feliu-Soler","year":"2018","journal-title":"J Appl Biobehav Res"},{"key":"2025120523473305000_12.1.e055351.53","first-page":"77","article-title":"[Spanish version of the new World Health Organization Disability Assessment Schedule II (WHO-DAS-II): initial phase of development and pilot study. Cantabria disability work group]","volume":"28","author":"V\u00e1zquez-Barquero","year":"2000","journal-title":"Actas Esp Psiquiatr"},{"key":"2025120523473305000_12.1.e055351.54","first-page":"28","article-title":"Psychometric validation of the world health organization disability assessment schedule 2.0-12-item version in persons with fibromyalgia syndrome","volume":"82","author":"Smedema","year":"2016","journal-title":"J Rehabil"},{"key":"2025120523473305000_12.1.e055351.55","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.166.10.1092"},{"key":"2025120523473305000_12.1.e055351.56","doi-asserted-by":"crossref","first-page":"1400","DOI":"10.1111\/pme.12168","article-title":"Longitudinal observation of treatment patterns and outcomes for patients with fibromyalgia: 12-month findings from the REFLECTIONS study","volume":"14","author":"Robinson","year":"2013","journal-title":"Pain Med"},{"key":"2025120523473305000_12.1.e055351.57","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2013.03.003"},{"key":"2025120523473305000_12.1.e055351.58","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-011-9903-x"},{"key":"2025120523473305000_12.1.e055351.59","first-page":"171","article-title":"Spanish version of the CSRI: a mental health cost evaluation interview","volume":"60","author":"V\u00e1zquez-Barquero","year":"1997","journal-title":"Arch Neurobiol"},{"key":"2025120523473305000_12.1.e055351.60","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1016\/j.jpain.2015.02.007","article-title":"Patients\u2019 impression of change following treatment for chronic pain: global, specific, a single dimension, or many?","volume":"16","author":"Scott","year":"2015","journal-title":"J Pain"},{"key":"2025120523473305000_12.1.e055351.61","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1016\/j.jpain.2018.01.006","article-title":"Ecological momentary assessment methodology in chronic pain research: a systematic review","volume":"19","author":"May","year":"2018","journal-title":"J Pain"},{"key":"2025120523473305000_12.1.e055351.62","doi-asserted-by":"crossref","DOI":"10.3390\/jcm8040465","article-title":"Current state and future directions of technology-based ecological momentary assessment and intervention for major depressive disorder: a systematic review","volume":"8","author":"Colombo","year":"2019","journal-title":"J Clin Med"},{"key":"2025120523473305000_12.1.e055351.63","doi-asserted-by":"crossref","first-page":"900","DOI":"10.1097\/AJP.0000000000000618","article-title":"Validity, reliability, feasibility, and usefulness of pain monitor: a multidimensional smartphone APP for daily monitoring of adults with heterogenous chronic pain","volume":"34","author":"Suso-Ribera","year":"2018","journal-title":"Clin J Pain"},{"key":"2025120523473305000_12.1.e055351.64","doi-asserted-by":"crossref","DOI":"10.2196\/11398","article-title":"What affects the completion of ecological momentary assessments in chronic pain research? An individual patient data meta-analysis","volume":"21","author":"Ono","year":"2019","journal-title":"J Med Internet Res"},{"key":"2025120523473305000_12.1.e055351.65","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1097\/AJP.0000000000000797","article-title":"The complex interplay of pain, depression, and anxiety symptoms in patients with chronic pain: a network approach","volume":"36","author":"G\u00f3mez Penedo","year":"2020","journal-title":"Clin J Pain"},{"key":"2025120523473305000_12.1.e055351.66","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0060188"},{"key":"2025120523473305000_12.1.e055351.67","doi-asserted-by":"crossref","first-page":"1","DOI":"10.18637\/jss.v088.i02","article-title":"JASP: Graphical statistical software for common statistical designs","volume":"88","author":"Love","year":"2019","journal-title":"J Stat Softw"},{"key":"2025120523473305000_12.1.e055351.68","doi-asserted-by":"crossref","first-page":"2253","DOI":"10.1093\/pm\/pnaa001","article-title":"Low-dose naltrexone for the treatment of fibromyalgia: investigation of dose-response relationships","volume":"21","author":"Bruun-Plesner","year":"2020","journal-title":"Pain Med"},{"key":"2025120523473305000_12.1.e055351.69","doi-asserted-by":"crossref","DOI":"10.1186\/s13063-021-05776-7","article-title":"Low dose naltrexone for the treatment of fibromyalgia: protocol for a double-blind, randomized, placebo-controlled trial","volume":"22","author":"Bruun","year":"2021","journal-title":"Trials"},{"key":"2025120523473305000_12.1.e055351.70","doi-asserted-by":"publisher","DOI":"10.1007\/s11916-020-0834-5"},{"key":"2025120523473305000_12.1.e055351.71","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1016\/j.adaj.2020.08.019","article-title":"Use of low-dose naltrexone in the management of chronic pain conditions: a systematic review","volume":"151","author":"Hatfield","year":"2020","journal-title":"J Am Dent Assoc"},{"key":"2025120523473305000_12.1.e055351.72","doi-asserted-by":"crossref","DOI":"10.3389\/fpsyt.2021.593842","article-title":"The effects of low dose naltrexone on opioid induced hyperalgesia and fibromyalgia","volume":"12","author":"Jackson","year":"2021","journal-title":"Front Psychiatry"},{"key":"2025120523473305000_12.1.e055351.73","doi-asserted-by":"crossref","first-page":"746","DOI":"10.1002\/hec.3633","article-title":"Estimating a cost-effectiveness threshold for the Spanish NHS","volume":"27","author":"Vallejo-Torres","year":"2018","journal-title":"Health Econ"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2021-055351","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T07:47:42Z","timestamp":1765007262000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2021-055351"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1]]},"references-count":73,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,1,6]]},"published-print":{"date-parts":[[2022,1]]}},"alternative-id":["10.1136\/bmjopen-2021-055351"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2021-055351","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1]]}}}