Efficacy of medications for the treatment of alcohol use disorder (AUD): A systematic review and meta-analysis considering baseline AUD severity.

Autor: Agabio R; Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, Monserrato, CA, Italy. Electronic address: agabio@unica.it., Lopez-Pelayo H; Health and Addictions Research Group, IDIBAPS, Addictions Unit. Psychiatry and Psychology Service, ICN, Hospital Clinic Barcelona, Barcelona, Spain., Bruguera P; Health and Addictions Research Group, IDIBAPS, Addictions Unit. Psychiatry and Psychology Service, ICN, Hospital Clinic Barcelona, Barcelona, Spain., Huang SY; Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan., Sardo S; Department of Medical Sciences and Public Health, University of Cagliari, Monserrato, CA, Italy., Pecina M; Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA., Krupitsky EM; Department of Addictions, Bekhterev National Medical Research Center for Psychiatry and Neurology, Bekhtereva street, 3, St. Petersburg 192019, Russia; Valdman Institute of Pharmacology, First St.-Petersburg Pavlov State Medical University, Lev Tolstoy Street, 6-8, St-Petersburg 197022, Russia., Fitzmaurice GM; Laboratory for Psychiatric Biostatistics, McLean Hospital, Belmont, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA., Lin Z; Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Laboratory for Psychiatric Neurogenomics, McLean Hospital, Belmont, MA, USA.
Jazyk: angličtina
Zdroj: Pharmacological research [Pharmacol Res] 2024 Nov; Vol. 209, pp. 107454. Date of Electronic Publication: 2024 Oct 11.
DOI: 10.1016/j.phrs.2024.107454
Abstrakt: Baseline severity of alcohol use disorder (AUD) is an influencing factor in the response to medications recommended for the treatment of AUD. The scarce efficacy of AUD medications partly justifies their limited uses. We were interested in evaluating the efficacy of approved and recommended AUD medications using generic inverse-variance, an analysis facilitating comparison between medications and placebo both at the end of the study and, concomitantly, to baseline values for the same participants. We conducted a systematic review to include randomized controlled trials (RCTs) comparing any medication to placebo providing, both at baseline and end of treatment, percent heavy drinking days (%HDD), percent drinking days (%DD), and/or drinks per drinking day (DDD). We searched PubMed, Embase, PMC, and three CT registers from inception to April 2023. A total of 79 RCTs (11,737 AUD participants; 30 different medications) were included: 47 RCTs (8465 participants) used AUD medications, and 32 RCTs (3272 participants) used other medications. At baseline, participants consumed on average approximately 12 DDD, and experienced 70 % DD, and 61 % HDD. Placebo halved or reduced these values to a third. Compared to placebo, AUD medications further reduced these outcomes (moderate to high certainty evidence). Other medications reduced the DDD without modifying other alcohol outcomes. AUD medications increased the risk of developing adverse events (high-certainty evidence). Despite the large placebo effects, our results support the benefits of providing AUD medications to people with AUD, helping them reduce alcohol consumption.
Competing Interests: Declaration of Competing Interest On behalf of all authors, I state that: (a) each author has contributed significantly to the work and agrees to submission of the manuscript, (b) none of the original material contained in the manuscript has been submitted for consideration nor will any of it be published elsewhere, and (c) each author has no conflict of interest that is directly relevant to the content of this manuscript.
(Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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