Translating medication effects for alcohol use disorder across preclinical, human laboratory, and clinical trial outcomes using meta-analysis.

Animal models are used for preliminary testing of novel compounds for alcohol use disorder (AUD). However, it is unclear whether early efficacy in preclinical models reliably predicts efficacy in human laboratory and clinical trials. We searched the literature for medications tested for AUD in preclinical models (i.e., two-bottle choice [2-BC] and operant reinstatement), human laboratory cue-reactivity, and randomized clinical trials (RCTs). For preclinical models, we computed medication effects on 2-BC alcohol preference and consumption (k = 77 studies, 14 medications) as well as operant reinstatement (k = 18 studies, 8 medications). For human laboratory studies, we computed medication effects on alcohol cue-induced craving (k = 36 studies, 15 medications). For RCTs, we computed medication effects on RCT endpoints including return to any drinking and return to heavy drinking (k = 139 studies, 19 medications). We used medication as the unit of analysis and applied the Williamson-York bivariate weighted least squares estimation to preserve the errors in both the independent and dependent variables. Medication effects on 2-BC alcohol preference (