Oxygen-ozone autohaemotherapy in fibromyalgia: safety profile and adverse events. A scoping review
Casale R, Petrikonis K, Ahmadian A, Bazzichi L, et al. Clinical and Experimental Rheumatology, 2026.
- Study type
- Review
- People studied
- No participants of its own (review)
- Population
- Published reports, mostly case reports, of adverse events after systemic oxygen-ozone autohaemotherapy in the last decade, largely from mixed clinical populations rather than fibromyalgia
- Published
- 2026, Clinical and Experimental Rheumatology
- Identifiers
- PMID 42328943, DOI 10.55563/clinexprheumatol/l4g4nf
What the authors reported
The search found mainly case reports of adverse events: haemolysis and renal failure with ozone above 60 μg/mL, hyperkalaemia, myocardial infarction and ischaemic events, cerebral gas embolism with patent foramen ovale, autonomic reactions to rapid reinfusion, anaphylaxis linked to equipment, and infections from protocol breaches. The authors state incidence cannot be reliably quantified.
What limits this result
Scoping review, read from the abstract only. It draws mostly on case reports from mixed clinical populations, covers the last decade and systemic routes only, and the authors state that incidence cannot be reliably quantified given the absence of prospective registries and reliable denominator data.
Harms reported after ozone therapy, and studies of how ozone exposure affects health. One study rarely settles a medical question; our guides weigh each paper against the rest of the evidence.
How the study was done
- Design
- Scoping review of documented adverse events of oxygen-ozone autohaemotherapy, following PRISMA-ScR guidelines
This scoping review aimed to systematically evaluate documented adverse events associated with O2-O3-AHT and assess risk stratification.
- Setting
- Opusmedica, Persons Care & Research NPO, Piacenza, Italy (first-listed affiliation)
- Read from
- Read from the abstract only; where this page says nothing about an item, the abstract does not report it. Read on October 2, 2026.
Source: Abstract on PubMed
What it measured
- Search
- Nine databases searched for articles published in the last decade, following PRISMA-ScR guidelines
Following PRISMA-ScR guidelines, we searched Medline, EMBASE, AMED, Cochrane Library, CINAHL, Web of Science, TRIP, Clinical Evidence, and ROAD databases for relevant articles published in the last decade.
- Type of evidence found
- Predominantly case reports documenting rare but potentially serious adverse events
- Haemolysis and renal failure
- Associated with excessive ozone concentrations above 60 μg/mL
- Hyperkalaemia; myocardial infarction and ischaemic events
- Hyperkalaemia in patients with complex comorbidities; myocardial infarction and ischaemic events attributed to vasoconstrictive and pro-thrombotic effects
- Gas embolism, autonomic and anaphylactic reactions, infections
- Cerebral gas embolism with patent foramen ovale; autonomic reactions to rapid reinfusion; anaphylaxis linked to equipment materials; infections due to protocol breaches
- Overall incidence of serious adverse events
- Cannot be reliably quantified, given the absence of prospective registries and reliable denominator data
- Populations behind the safety data
- Mostly mixed clinical populations, not specifically fibromyalgia cohorts
- Authors' conclusion
- Current evidence does not identify a pattern of frequent serious unexpected harm when standardised protocol is followed
Source: Abstract on PubMed
Safety as reported
Rare but potentially serious adverse events, documented predominantly in case reports
Source: Abstract on PubMed
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