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| Alcohol and alcoholism (Oxford, Oxfordshire). 2023 Jan 6. doi: 10.1093/alcalc/agac070. pii: 6972911 |
| Sodium Oxybate for Alcohol Dependence: A Network Meta-Regression Analysis Considering Population Severity at Baseline and Treatment Duration. |
| Guiraud J1, Addolorato G2, Aubin HJ3, Bachelot S4, Batel P5, de Bejczy A6, Benyamina A7, Caputo F8, Couderc M9, Dematteis M10, Goudriaan AE11, Gual A12, Lecoustey S13, Lesch OM14, Maremmani I15, Nutt DJ16, Paille F17, Perney P18, Rehm J19, Rolland B20, Scherrer B21, Simon N22, Söderpalm B23, Somaini L24, Sommer WH25, Spanagel R26, Walter H27, van den Brink W28 |
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Abstract AIMS: The estimated effect of sodium oxybate (SMO) in the treatment of alcohol dependence is heterogeneous. Population severity and treatment duration have been identified as potential effect modifiers. Population severity distinguishes heavy drinking patients with <14 days of abstinence before treatment initiation (high-severity population) from other patients (mild-severity population). Treatment duration reflects the planned treatment duration. This study aimed to systematically investigate the effect of these potential effect moderators on SMO efficacy in alcohol-dependent patients. METHODS: Network meta-regression allows for testing potential effect modifiers. It was selected to investigate the effect of the above factors on SMO efficacy defined as continuous abstinence (abstinence rate) and the percentage of days abstinent (PDA). Randomized controlled trials for alcohol dependence with at least one SMO group conducted in high-severity and mild-severity populations were assigned to a high-severity and mild-severity group of studies, respectively. RESULTS: Eight studies (1082 patients) were retained: four in the high-severity group and four in the mild-severity group. The high-severity group was associated with larger SMO effect sizes than the mild-severity group: abstinence rate risk ratio (RR) 3.16, P = 0.004; PDA +26.9%, P < 0.001. For PDA, longer treatment duration was associated with larger SMO effect size: +11.3% per extra month, P < 0.001. In the high-severity group, SMO showed benefit: abstinence rate RR 2.91, P = 0.03; PDA +16.9%, P < 0.001. In the mild-severity group, SMO showed benefit only in PDA for longer treatment duration: +23.9%, P < 0.001. CONCLUSIONS: In the retained studies with alcohol-dependent patients, high-severity population and longer treatment duration were associated with larger SMO effect sizes. |
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© The Author(s) 2023. Medical Council on Alcohol and Oxford University Press. |
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Publikations ID: 36617267 Quelle: öffnen |
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