Evidence map›Paper›PMID 23075288›Full record

SynthesisAddiction (Abingdon, England)2013

Meta-analysis of naltrexone and acamprosate for treating alcohol use disorders: when are these medications most helpful?

Natalya C Maisel, Janet C Blodgett, Paula L Wilbourne, Keith Humphreys, John W Finney

2 registry-linked trialsAbstract readComparative StudyMeta-AnalysisReview
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Addiction (Abingdon, England), 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 226 papers, 21 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
226citing papers in PubMed, 21 pooled it
16.6field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04106739 nacompletednot on this mapstarted 2019, after this paper: background citation

Auricular Percutaneous Electrical Neural Field Stimulation in Short-Term Treatment of Alcohol Dependence- Neurohaemodynamic Correlates and Feasibility Study

TypeinterventionalSponsorDyAnsys, Inc.Ran2019 to 2021Enrolled44ConditionsAlcohol Use DisorderArmsDrug Relief V(version) 2.0 Auricular Percutaneous Electrical Neural Field Stimulation (PENFS)
NCT06636227 phase1recruitingnot on this mapstarted 2024, after this paper: background citation

Optimal Dosing, Tolerability, and Initial Efficacy of Diclofenac as a KMO Inhibitor in Individuals With Alcohol Use Disorder

TypeinterventionalSponsorUniversity of Maryland, BaltimoreRan2024 to 2026Enrolled24ConditionsAlcohol Use Disorder (AUD), Alcohol-Related DisordersArmsDiclofenac 100mg, Diclofenac 75mg, Diclofenac 50mg, Placebo control
3 · Its place in the literature

Who cites it

226 citing papers in PubMed, 21 syntheses or guidelines pooled it, 456 citations in OpenAlex.

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  4. Canadian guideline for the clinical management of high-risk drinking and alcohol use disorder.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2023
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  8. Genetic contributions to alcohol use disorder treatment outcomes: a genome-wide pharmacogenomics study.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2021
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  20. Guideline

166 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

Natalya C MaiselCenter for Health Care Evaluation, VA Palo Alto Health Care System (152MPD), Menlo Park, CA 94025, USA. ncmaisel@gmail.com
Janet C Blodgett
Paula L Wilbourne
Keith Humphreys
John W Finney
VA Palo Alto Health Care System · USStanford University · US

Funding

META-ANALYSIS OF ALCOHOLISM TREATMENT OUTCOME RESEARCHR01AA008689 · NIAAA · PALO ALTO VETERANS INSTIT FOR RESEARCH · PI FINNEY, JOHN W. · 1990 to 2011
$766k
NIAAA NIH HHS AA008689NIAAA NIH HHS R01 AA008689
6 · The paper itself

Abstract

aimsAlthough debates over the efficacy of oral naltrexone and acamprosate in treating alcohol use disorders tend to focus on their global efficacy relative to placebo or their efficacy relative to each other, the underlying reality may be more nuanced. This meta-analysis examined when naltrexone and acamprosate are most helpful by testing: (i) the relative efficacy of each medication given its presumed mechanism of action (reducing heavy drinking versus fostering abstinence) and (ii) whether different ways of implementing each medication (required abstinence before treatment, detoxification before treatment, goal of treatment, length of treatment, dosage) moderate its effects.

methodsA systematic literature search identified 64 randomized, placebo-controlled, English-language clinical trials completed between 1970 and 2009 focused on acamprosate or naltrexone.

resultsAcamprosate had a significantly larger effect size than naltrexone on the maintenance of abstinence, and naltrexone had a larger effect size than acamprosate on the reduction of heavy drinking and craving. For naltrexone, requiring abstinence before the trial was associated with larger effect sizes for abstinence maintenance and reduced heavy drinking compared with placebo. For acamprosate, detoxification before medication administration was associated with better abstinence outcomes compared with placebo.

conclusionsIn treatment for alcohol use disorders, acamprosate has been found to be slightly more efficacious in promoting abstinence and naltrexone slightly more efficacious in reducing heavy drinking and craving. Detoxification before treatment or a longer period of required abstinence before treatment is associated with larger medication effects for acamprosate and naltrexone respectively.

Indexed as

AcamprosateAlcohol DeterrentsAlcohol-Related DisordersEthanolHumansInactivation, MetabolicNaltrexoneNarcotic AntagonistsRandomized Controlled Trials as TopicTaurineTime FactorsTreatment OutcomeAcamprosateAlcohol DeterrentsEthanolNaltrexoneNarcotic AntagonistsTaurine

Identifiers

PMID23075288
PMCPMC3970823
OpenAlexW1910982087

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.