Evidence map›Paper›PMID 37267194›Full record

Trial reportJournal of addiction medicine

Extended-release Naltrexone Is Not Linked to Hepatotoxicity in Adults Experiencing Homelessness and Alcohol Use Disorder.

Philip Vutien, Nicole J Kim, Joseph O Merrill, Mark H Duncan, George N Ioannou, Susan E Collins

Open access · greenAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Journal of addiction medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.7field-weighted citation impact, top 16% 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

4 citing papers in PubMed, 4 citations in OpenAlex.

  1. Review
  2. Article
  3. Article
  4. Tobacco, cannabis, and the liver.Clinical liver disease
    Review
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

6 authors at 2 institutions in 2 countries.

Philip VutienFrom the Division of Gastroenterology, University of Washington, Seattle, WA (PV, NJK, GNI); Department of Medicine, University of Washington, Seattle, WA (JOM); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA (MHD, SEC); Division of Gastroenterology, VA Puget Sound Health Care System, Seattle, WA (GNI); and Department of Psychology, Washington State University, Spokane, WA (SEC).ORCID 0000-0002-4196-6077
Joseph O Merrill
Mark H Duncan
George N Ioannou
Susan E Collins
Saras Environment Consultant · INUniversity of Washington · US

Funding

UNIVERSITY OF WASHINGTON GI TRAINING GRANTT32DK007742 · NIDDK · UNIVERSITY OF WASHINGTON · PI GRADY, WILLIAM MALLORY · 1996 to 2022
$4.7M
Harm reduction with pharmacotherapy for homeless adults with alcohol dependenceR01AA022309 · NIAAA · UNIVERSITY OF WASHINGTON · PI COLLINS, SUSAN E · 2013 to 2017
$3.3M
NIAAA NIH HHS R01 AA022309NIDDK NIH HHS T32 DK007742
6 · The paper itself

Abstract

objectivesThe use of extended-release naltrexone (XR-NTX) as treatment for alcohol use disorder (AUD) has been limited by a prior black box warning for hepatotoxicity. We performed a secondary analysis of data from a randomized clinical trial to compare serum liver enzyme levels for those randomized to XR-NTX versus placebo.

methodsThe parent study aimed to test the efficacy of combined pharmacobehavioral harm-reduction treatment in improving alcohol and quality-of-life outcomes for adults experiencing homelessness and AUD. We compared the 2 arms that received intramuscular injections of either 380 mg XR-NTX (n = 74) or placebo (n = 77). Outcomes included ( a ) liver enzyme levels and ( b ) liver enzyme values categorized as normal (<1× upper limit of normal [ULN]), elevated (1-3× ULN), or high (>3× ULN). We performed multinomial logistic regression and negative binomial generalized estimating equations modeling to assess the effects of treatment group and the time × treatment group interaction on liver enzyme outcomes.

resultsThe mean age was 47.9 ± 9.9 years, and the mean baseline alcohol consumption was 23.2 ± 14.0 drinks per day. There were no significant differences in the development of liver enzyme elevations 1 to 3× ULN or more than 3× ULN (all P s > 0.25) or in the change in liver enzyme values (all P s > 0.41) between the placebo and the XR-NTX groups over the treatment course.

conclusionsIn our study of adults experiencing homelessness and AUD, receipt of XR-NTX was not associated with hepatotoxicity. These findings support the use of XR-NTX to treat AUD even in patients who are drinking heavily and physiologically dependent on alcohol.

Indexed as

AlcoholismChemical and Drug Induced Liver InjuryIll-Housed PersonsOpioid-Related DisordersAdultAlcohol DrinkingDelayed-Action PreparationsHumansInjections, IntramuscularMiddle AgedNaltrexoneNarcotic AntagonistsDelayed-Action PreparationsNaltrexoneNarcotic Antagonists

Identifiers

PMID37267194
PMCPMC10248188
OpenAlexW4318929967

What OpenQuestion holds

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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.