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2023-08-25

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Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/208744

Medications for alcohol use disorder promote abstinence in alcohol-related cirrhosis: results from a systematic review and meta-analysis

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https://doi.org/10.1097/HEP.0000000000000570

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Background and aims: The role of medications for alcohol use disorder (MAUD) in patients with cirrhosis is not well established. Evidence on the efficacy and safety of these drugs in these patients is scarce. Approach and results: We performed a systematic review and meta-analysis according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocol guidelines on the efficacy of MAUD in patients with cirrhosis. A search was conducted in PubMed, Embase, and Scopus, including all studies until May 2022. The population was defined as patients with AUD and cirrhosis. The primary outcome was alcohol abstinence. Safety was a secondary outcome. We performed a random-effect analysis and expressed the results as relative risk of alcohol consumption. Heterogeneity was measured by I2 . Out of 4095 unique references, 8 studies on 4 different AUD treatments [baclofen (n = 6), metadoxine (n = 1), acamprosate (n = 1), and fecal microbiota transplant (n = 1)] in a total of 794 patients were included. Four were cohort studies, and 4 were RCTs. Only RCTs were included in the meta-analysis. MAUD was associated with a reduced rate of alcohol consumption [relative risk = 0.68 (CI: 0.48-0.97), P = 0.03], increasing alcohol abstinence by 32% compared to placebo or standard treatment, despite high heterogeneity ( I2 = 67%). Regarding safety, out of 165 serious adverse events in patients treated with MAUD, only 5 (3%) were possibly or probably related to study medications. Conclusion: MAUD in patients with cirrhosis is effective in promoting alcohol abstinence and has a good safety profile. Larger studies on the effects of MAUD are needed, especially in patients with advanced liver disease.

Matèries

Administració de medicaments, Cirrosi hepàtica, Alcoholisme, Ressenyes sistemàtiques (Investigació mèdica), Metaanàlisi

Matèries (anglès)

Administration of drugs, Hepatic cirrhosis, Alcoholism, Systematic reviews (Medical research), Meta-analysis

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Col·leccions

Articles publicats en revistes (Medicina)
Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)

Citació

GRATACÓS GINÈS, Jordi, BRUGUERA SOLER, Pol, PÉREZ-GUASCH, Martina, LÓPEZ LAZCANO, Ana, BORRÀS, Roger, HERNÁNDEZ ÉVOLE, Helena, PONS-CABRERA, Maria teresa, LLIGOÑA, Anna, BATALLER ALBEROLA, Ramón, GINÈS I GIBERT, Pere, LÓPEZ PELAYO, Hugo, POSE MÉNDEZ, Elisa. Medications for alcohol use disorder promote abstinence in alcohol-related cirrhosis: results from a systematic review and meta-analysis. _Hepatology_. 2023. [consulta: 31 de desembre de 2025]. ISSN: 0270-9139. [Disponible a: https://hdl.handle.net/2445/208744]

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