Novel Agents for the Pharmacological Treatment of Alcohol Use Disorder.
Novel Agents for the Pharmacological Treatment of Alcohol Use Disorder.
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DOI：
10.1007/s40265-021-01670-3
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发表时间：
2022-03
期刊：
影响因子：
11.5
通讯作者：
Ray LA
中科院分区：
文献类型：
--
作者：
Burnette EM;Nieto SJ;Grodin EN;Meredith LR;Hurley B;Miotto K;Gillis AJ;Ray LA
酒精使用障碍（AUD）是一种非常普遍但治疗严重不足的疾病，只有三种广泛批准的药物治疗。鉴于AUD是一种非常异质性的疾病，一种单一的药物不太可能对所有患有AUD的个体有效。因此，需要开发新的、更有效的和多样化的AUD药物治疗选择，希望提高利用率和改善护理。在这篇定性文献综述中，我们从临床角度讨论了用于治疗AUD的已批准、再利用和新型药物疗法的疗效、作用机制和耐受性。讨论的药物治疗包括：双硫仑、阿坎酸、纳洛酮、纳美芬、托吡酯、加巴喷丁、伐尼克兰、巴氯芬、羟丁酸钠、阿立哌唑、昂丹司琼、米非司酮、异丁司特、苏沃雷生、哌唑嗪、多沙唑嗪、N-乙酰半胱氨酸、GET 73、ASP 8062、ABT-436、PF-5190457和大麻二酚。总体而言，本综述中讨论的许多重新利用的新型药物证明了临床有效性，并有望成为AUD治疗的未来。重要的是，这些药物还为异质性AUD人群的精准医学和个性化治疗的发展提供了潜在的改进。然而，仍然非常需要改善治疗的可及性，增加批准的药物治疗菜单，消除对AUD的污名化并增加寻求治疗的人数。
Alcohol use disorder (AUD) is a highly prevalent but severely under-treated disorder, with only three widely-approved pharmacotherapies. Given that AUD is a very heterogeneous disorder, it is unlikely that one single medication will be effective for all individuals with an AUD. As such, there is a need to develop new, more effective, and diverse pharmacological treatment options for AUD with the hopes of increasing utilization and improving care. In this qualitative literature review, we discuss the efficacy, mechanism of action, and tolerability of approved, repurposed, and novel pharmacotherapies for the treatment of AUD with a clinical perspective. Pharmacotherapies discussed include: disulfiram, acamprosate, naltrexone, nalmefene, topiramate, gabapentin, varenicline, baclofen, sodium oxybate, aripiprazole, ondansetron, mifepristone, ibudilast, suvorexant, prazosin, doxazosin, N-acetylcysteine, GET73, ASP8062, ABT-436, PF-5190457, and cannabidiol. Overall, many repurposed and novel agents discussed in this review demonstrate clinical effectiveness and promise for the future of AUD treatment. Importantly, these medications also offer potential improvements towards the advancement of precision medicine and personalized treatment for the heterogeneous AUD population. However, there remains a great need to improve access to treatment, increase the menu of approved pharmacological treatments, and de-stigmatize and increase treatment-seeking for AUD.
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