Baclofen promotes alcohol abstinence in alcoholics with liver cirrhosis

December 06, 2007

The drug baclofen is effective at promoting alcohol abstinence in alcohol-dependent patients with liver cirrhosis, and could have an important role in treatment of these individuals. These are the conclusions of authors of an Article published in this week's edition of The Lancet.

Alcohol remains the most frequent cause of liver cirrhosis in developed countries. Persistent alcohol intake in people with alcoholic cirrhosis is associated with high mortality. The most effective management strategy for these individuals is to achieve total alcohol abstinence, since medical and surgical treatments for alcoholic liver diseases have limited success when drinking continues.

Dr Giovanni Addolorato, Institute of Internal Medicine, Catholic University of Rome, Italy, and colleagues did a trial of 148 alcohol-dependent patients with liver cirrhosis that had been referred to their institute. 84 of these were randomised to receive either oral baclofen (42) or placebo (42). Total alcohol abstinence and duration of this abstinence were assessed during outpatient visits, with relapse defined as alcohol intake of more than four standard drinks per day or overall consumption of 14 or more standard drinks per week over a period of at least four weeks. One standard drink was defined as equal to 12g absolute alcohol.

The researchers found that 71% of the baclofen patients (30/42) achieved and maintained alcohol abstinence, compared to 29% (12/42) of those receiving placebo. Patients taking baclofen also abstained from alcohol for more than twice as long as patients given placebo (62.8 days versus 30.8 days).

The authors say: "Our results show that oral administration of baclofen is significantly more effective than placebo at achieving and maintaining alcohol abstinence and at increasing cumulative abstinence duration in alcohol-dependent patients with liver cirrhosis. This reduction in self-reported alcohol use was associated with significant reductions in clinical markers of liver injury, findings that confirm self-reported data and suggest that the reduction in alcohol consumption was sufficient to lessen liver injury."

They conclude: "Our results suggest that baclofen, because of its anticraving action and safety, could have an important role for treatment of alcohol-dependent patients with advanced liver disease."

In an accompanying Comment, Dr James Garbutt, Department of Psychiatry, University of North Carolina, USA, and Dr Barbara Flannery, Transdisciplinary Behavioural Science Programme, RTI International, Baltimore, MD, USA, say that many drug trials for alcoholism exclude those with medical, psychiatric, and comorbid substance misuse problems, and thus their validity in real-world settings is reduced.

However they conclude: "Despite the scientific success of discovering effective drugs for alcoholism, use of these medications by clinicians has lagged. The findings of modern clinical trials, such as the one reported by Addolorato and colleagues, should be transferred to primary care settings if these treatments are to substantially affect public health."
-end-
Dr Giovanni Addolorato, Institute of Internal Medicine, Catholic University of Rome, Italy T) +39 (0) 6 30154334 / +39-333-3783613 E) g.addolorato@rm.unicatt.it

Dr James Garbutt, Department of Psychiatry, University of North Carolina, USA T) +1 919-966-4652 E) jc_garbutt@med.unc.edu

View the paper associated with this release at the link below:

http://multimedia.thelancet.com/pdf/press/Baclofen.pdf

Lancet

Related Alcohol Consumption Articles from Brightsurf:

Excessive alcohol consumption during the COVID-19 pandemic
The full impact of COVID-19 on alcohol use is not yet known, but rates have been rising during the first few months of the pandemic.

Alcohol consumption rises sharply during pandemic shutdown
Anecdotal information has suggested that people are buying and consuming more alcohol during the pandemic shutdown.

Associations of alcohol consumption, alcohol-induced passing out with risk of dementia
The risk of future dementia associated with overall alcohol consumption and alcohol-induced loss of consciousness in a population of current drinkers was examined in this observational study with more than 131,000 adults.

Sweet coolers a gateway to increased alcohol consumption
Sweetened alcoholic beverages can promote harmful alcohol consumption among teens, new University of Guelph research finds.

The influence of alcohol consumption among cohabitating partners
Research has linked a partner's or spouse's drinking with changes in alcohol-related behaviors, but few studies have considered only cohabiting relationships.

Does alcohol consumption have an effect on arthritis?
Several previous studies have demonstrated that moderate alcohol consumption is linked with less severe disease and better quality of life in patients with rheumatoid arthritis, but a new Arthritis Care & Research study suggests that this might not be because drinking alcohol is beneficial.

Is alcohol consumption more helpful than harmful? It depends on your age
Studies of health effects of alcohol consumption may underestimate the risks of imbibing, particularly for younger people, according to a new study in the Journal of Studies on Alcohol and Drugs.

Link between alcohol consumption and breast cancer ignored by women most at risk
Middle aged women in Australia aren't getting the message about the proven link between alcohol consumption and breast cancer, at a time when more are drinking while cancer rates in their age bracket are increasing, according to a new study.

How much is too much? Even moderate alcohol consumption is a risk factor for atrial fibrillation
Excessive alcohol consumption is an established risk factor for atrial fibrillation (AF), but what are the effects of moderate and mild consumption on AF?

Moderate consumption of alcohol is associated with fewer hospitalizations
A study of the Department of Epidemiology and Prevention of I.R.C.C.S.

Read More: Alcohol Consumption News and Alcohol Consumption Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.