Evidence map›Paper›PMID 34120366›Full record

ArticleAlcoholism, clinical and experimental research2021

World Health Organization risk drinking levels as a treatment outcome measure in topiramate trials.

Emily E Hartwell, Richard Feinn, Katie Witkiewitz, Timothy Pond, Henry R Kranzler

Open access · greenAbstract read
In one paragraph

Article in Alcoholism, clinical and experimental research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.2field-weighted citation impact, top 21% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 12 citations in OpenAlex.

  1. Trial
  2. Trial
  3. Article
  4. Review
  5. Hazardous drinking and alcohol use disorders.Nature reviews. Disease primers · 2022
    Review
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 1 country.

Emily E HartwellMental Illness Research, Education and Clinical Center, Crescenz VAMC, Philadelphia, PA, USA.ORCID 0000-0002-5137-9714
Richard FeinnDepartment of Medical Sciences, Frank H. Netter School of Medicine, Quinnipiac University, North Haven, CT, USA.
Katie WitkiewitzDepartment of Psychology (KW), Center on Alcohol, Substance Use, and Addictions, University of New Mexico, Albuquerque, NM, USA.ORCID 0000-0002-1086-3067
Timothy PondMental Illness Research, Education and Clinical Center, Crescenz VAMC, Philadelphia, PA, USA.
Henry R KranzlerMental Illness Research, Education and Clinical Center, Crescenz VAMC, Philadelphia, PA, USA.ORCID 0000-0002-1018-0450
Philadelphia VA Medical Center · USQuinnipiac University · USUniversity of New Mexico · US

Funding

Vulnerabilities for coping-related drinking among post-college young adultsP60AA003510 · NIAAA · UNIVERSITY OF CONNECTICUT SCH OF MED/DNT · PI BAUER, LANCE O. · 2008 to 2017
$17.5M
WHO COLLABORATIVE PROJECT ON MANAGEMENT OF HARMFUL ALCOHOL CONSUMPTIONP50AA003510 · NIAAA · UNIVERSITY OF CONNECTICUT SCH OF MED/DNT · PI HESSELBROCK, VICTOR M · 1985 to 2007
$13.6M
Precision Medicine and Recovery in a Telehealth Treatment Program for Alcohol Use DisorderR01AA022328 · NIAAA · UNIVERSITY OF NEW MEXICO · PI Katie A Witkiewitz · 2013 to 2026
$3.1M
Pharmacogenetic Analysis of Topiramate Treatment of AUDR01AA023192 · NIAAA · UNIVERSITY OF PENNSYLVANIA · PI KRANZLER, HENRY RICHARD · 2014 to 2018
$2.7M
Mechanisms of Behavior Change in Alcohol Use Disorder TreatmentR01AA025539 · NIAAA · UNIVERSITY OF NEW MEXICO · PI TOFIGHI, DAVOOD, WITKIEWITZ, KATIE A · 2017 to 2021
$2.1M
Novel Approaches to Alcoholism Pharmacotherapy and RiskK24AA013736 · NIAAA · UNIVERSITY OF PENNSYLVANIA · PI KRANZLER, HENRY RICHARD · 2002 to 2012
$1.5M
NIAAA NIH HHS K24 AA013736NIAAA NIH HHS P50 AA003510NIAAA NIH HHS P60 AA003510NIAAA NIH HHS P60 AA03510NIAAA NIH HHS R01 AA022328NIAAA NIH HHS R01 AA023192NIAAA NIH HHS R01 AA025539
6 · The paper itself

Abstract

backgroundAlthough abstinence has traditionally been considered the only suitable outcome for alcohol treatment, reduced drinking is also associated with improved functioning and medical and psychiatric outcomes. The World Health Organization (WHO) risk drinking levels (RDLs) have been shown to be valid outcome measures in treatment trials for alcohol use disorder (AUD).

methodsWe conducted a secondary analysis of two 12-week, randomized controlled trials (RCTs), in which a total of 308 individuals with problematic alcohol use received topiramate or placebo treatment. We compared the utility of the WHO RDLs with other treatment outcomes, including self-reported measures of alcohol consumption, alcohol-related problems, and quality of life, and the biomarker gamma-glutamyltransferase.

resultsTopiramate treatment was associated with small effect sizes for both a 1-level (d = 0.26) and a 2-level (d = 0.19) reduction in WHO RDL, effects that were not significant after correction for multiple comparisons. No heavy drinking days, one of the outcome measures recommended by the US Food and Drug Administration for alcohol medication registration trials, also exhibited a small effect (0.21), while an effect size for abstinence could not be calculated. There were medium effects of topiramate on continuous measures of percent heavy drinking days (d = 0.49) and alcohol-related problems (d = 0.41).

conclusionsTopiramate is an efficacious pharmacotherapy for AUD. Although continuous measures of drinking and alcohol-related problems yielded larger effect sizes than the WHO RDLs, the latter nonetheless provide a categorical alternative for use in both clinical care and pharmacotherapy trials.

Indexed as

Alcohol DrinkingAdultAlcoholismAnticonvulsantsFemaleHumansMaleMiddle AgedOutcome Assessment, Health CareTopiramateWorld Health OrganizationAnticonvulsantsTopiramatealcohol use disorderheavy drinkingtopiramateWorld Health Organization risk drinking levels

Identifiers

PMID34120366
PMCPMC9439581
OpenAlexW3171173908

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.