Are medication effects on subjective response to alcohol and cue-induced craving associated? A meta regression study.
Are medication effects on subjective response to alcohol and cue-induced craving associated? A meta regression study.
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DOI：
10.1007/s00213-023-06409-4
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发表时间：
2023-09
影响因子：
3.4
通讯作者：
Du, Han
中科院分区：
文献类型：
--
作者：
Ray, Lara A.;Nieto, Steven J.;Meredith, Lindsay R.;Burnette, Elizabeth;Donato, Suzanna;Magill, Molly;Du, Han
酒精给药和线索反应范式经常用于筛选酒精使用障碍（AUD）药物的初始疗效。虽然药物对这些范例的主要结局的影响被认为是定性相关的，但严重缺乏定量证据支持这一假设。本研究的目的是测试药物效应量的主观反应，酒精管理和药物效应量的线索诱导的渴望线索曝光，使用荟萃分析之间的关系。进行了系统性文献检索，以确定随机试验，其中使用酒精给药和/或线索反应性范式测试AUD药物。从这些研究中，收集描述性统计量，以计算每个相应范例的主要结局的药物效应量。以药物作为分析单位，使用Williamson-York回归将酒精给药研究中的药物效应量与线索反应性研究中的药物效应量进行比较，该回归允许跨独立样本进行荟萃回归。酒精诱导刺激和酒精诱导渴求的药物效应量与线索诱导酒精渴求的药物效应量无显著相关性（k刺激= 10种药物，k渴求= 11种药物，（SE = 0.237））。酒精诱导镇静的药物效应量与线索诱导渴求的药物效应显著相关（k = 10种药物，（SE = 0.258），），因此增加酒精诱导镇静的药物更可能减少线索诱导的酒精渴求。除了酒精诱导的镇静作用外，几乎没有定量证据表明药物对酒精给药过程中测量的主观反应领域的影响与药物对线索诱导的酒精渴望的影响平行。为了给目前的研究提供更多的背景，未来的工作应该检查线索反应性结果是否能预测临床试验的结果。在线版本包含补充材料，可通过10.1007/s 00213 -023-06409-4获得。
Alcohol administration and cue-reactivity paradigms are frequently used to screen for the initial efficacy of medications for alcohol use disorder (AUD). While medication effects on the primary outcomes for these paradigms are assumed to be qualitatively related, there is a critical lack of quantitative evidence to support this hypothesis. The study aims to test the relationship between medication effect sizes on subjective response to alcohol administration and medication effect sizes for cue-induced craving to cue exposure, using meta-analysis. Systematic literature searches were conducted to identify randomized trials, wherein AUD medications were tested using the alcohol administration and/or cue-reactivity paradigms. From these studies, descriptive statistics were collected to compute medication effect sizes on the primary outcomes for each respective paradigm. With medication as the unit of analysis, medication effect sizes in alcohol administration studies were compared with medication effect sizes in cue-reactivity studies using the Williamson-York regression which allows for meta-regression across independent samples. Medication effect sizes on alcohol-induced stimulation and alcohol-induced craving were not significantly associated with medication effect sizes on cue-induced alcohol craving (k stimulation = 10 medications, and k craving = 11 medications, (SE = 0.237), ), respectively. Medication effect sizes on alcohol-induced sedation were significantly associated with medication effects on cue-induced craving (k = 10 medications, (SE = 0.258), ), such that medications that increased alcohol-induced sedation were more likely to reduce cue-induced alcohol craving. With the exception of alcohol-induced sedation, there is little quantitative evidence of medication effects on subjective response domains measured during alcohol administration parallel medication effects on cue-induced alcohol craving. To provide additional context to the current study, future work should examine whether cue-reactivity findings predict clinical trial outcomes. The online version contains supplementary material available at 10.1007/s00213-023-06409-4.
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