Evidence map›Paper›PMID 40445294›Full record

Trial reportAlcohol, clinical & experimental research2025

Moderation of treatment outcomes by polygenic risk for alcohol-related traits in placebo-controlled trials of topiramate.

Henry R Kranzler, Zeal Jinwala, Christal N Davis, Heng Xu, Joanna M Biernacka, Hang Zhou, Rachel L Kember, Joel Gelernter, Richard Feinn

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Alcohol, clinical & experimental research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Trial
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

9 authors.

Henry R KranzlerDepartment of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.ORCID 0000-0002-1018-0450
Zeal JinwalaDepartment of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
Christal N DavisDepartment of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.ORCID 0000-0003-3974-5598
Heng XuDepartment of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
Joanna M BiernackaDepartment of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA.
Hang ZhouDepartment of Psychiatry, Yale University School of Medicine and VA CT Healthcare Center, West Haven, Connecticut, USA.
Rachel L KemberDepartment of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.ORCID 0000-0001-8820-2659
Joel GelernterDepartment of Psychiatry, Yale University School of Medicine and VA CT Healthcare Center, West Haven, Connecticut, USA.
Richard FeinnDepartment of Medical Sciences, Frank H. Netter School of Medicine at Quinnipiac University, North Haven, Connecticut, USA.

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 PETRY, NANCY M · 1985 to 2007
$13.6M
Pharmacogenetic Analysis of Topiramate Treatment of AUDR01AA023192 · NIAAA · UNIVERSITY OF PENNSYLVANIA · PI KRANZLER, HENRY RICHARD · 2014 to 2018
$2.7M
Leveraging GWAS Findings to Map Variants and Identify Novel Effector Genes for Alcohol-Related TraitsR01AA030056 · NIAAA · UNIVERSITY OF PENNSYLVANIA · PI Struan F A Grant, MATTHEW S KAYSER · 2023 to 2026
$2.5M
Novel Approaches to Alcoholism Pharmacotherapy and RiskK24AA013736 · NIAAA · UNIVERSITY OF PENNSYLVANIA · PI KRANZLER, HENRY RICHARD · 2002 to 2012
$1.5M
Characterizing the phenotypic spectrum associated with genetic liability for alcohol use disorderK01AA028292 · NIAAA · UNIVERSITY OF PENNSYLVANIA · PI KEMBER, RACHEL LORRAINE · 2021 to 2024
$505k
NIAAA NIH HHS AA013736NIAAA NIH HHS AA023192NIAAA NIH HHS AA028292NIAAA NIH HHS AA030056NIAAA NIH HHS AA03510NIAAA NIH HHS K01 AA028292NIAAA NIH HHS K24 AA013736NIAAA NIH HHS P50 AA003510NIAAA NIH HHS P60 AA003510NIAAA NIH HHS R01 AA023192NIAAA NIH HHS R01 AA030056U.S. Department of Veterans Affairs
6 · The paper itself

Abstract

backgroundIn two 12-week, randomized, placebo-controlled trials (RCTs) in individuals with alcohol use disorder (AUD), topiramate significantly reduced heavy drinking days (HDDs), and alcohol-related problems. In a secondary analysis of those findings, we examined four broad measures of genetic risk-polygenic scores (PGS)-of problematic alcohol use (PAU), drinks per week (DPW), and time to relapse to any drinking (TR) and heavy drinking (THR) as moderators of topiramate's effect on HDDs and alcohol-related problems.

methodsWe analyzed data from 285 individuals with AUD (65.6% male) of European-like ancestry, who were treated with either topiramate (49.1%) or placebo (50.9%). All patients underwent genome-wide array genotyping, and PGS were calculated using summary statistics from genome-wide association studies of PAU, DPW, and TR and THR (two time-to-event outcomes among patients treated in AUD pharmacotherapy trials). We hypothesized an interaction effect in which greater genetic risk-particularly for PAU-would be associated with a greater therapeutic response to topiramate than placebo.

resultsAs shown previously, topiramate significantly reduced both HDDs (odds ratio [OR] = 0.50, p < 0.001) and Short Index of Problems (SIP) scores (b = -3.04, p < 0.001) more than placebo. There were nonsignificant associations of higher PGS with more HDDs (OR = 1.17, 95% CI = 0.98-1.41, p = 0.091) and a greater reduction in HDDs in the topiramate group (OR = 0.80, 95% CI = 0.62-1.03, p = 0.089). There were also significant interaction effects with treatment on SIP score by PGS for PAU (b = -1.64, SE = 0.78, p = 0.033), TR (b = -2.16, SE = 0.72, p = 0.003), and TRH (b = -2.17, SE = 0.72, p = 0.003).

conclusionsThese findings provide proof of principle for the use of alcohol-related PGS as moderators of the effects of topiramate for treating AUD. Larger RCTs of topiramate are needed to provide adequate statistical power to validate this pharmacogenetic approach to precision AUD treatment.

Indexed as

AlcoholismFructoseMultifactorial InheritanceTopiramateAdultFemaleGenetic Predisposition to DiseaseGenome-Wide Association StudyHumansMaleMiddle AgedTreatment OutcomeFructoseTopiramatealcohol‐related outcomesalcohol use disorderpharmacogeneticsprecision medicinetopiramate

Identifiers

PMID40445294
PMCPMC12173784

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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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.