Effect of Extended-Release Naltrexone on Alcohol Consumption: A Systematic Review and Meta-analysis.
Effect of Extended-Release Naltrexone on Alcohol Consumption: A Systematic Review and Meta-analysis.
复制标题
缓释纳曲酮对酒精消耗的影响：系统评价和荟萃分析。
作者：
Charles E. Murphy;Ralph C. Wang;J. Montoy;Evans Whittaker;M. Raven
目标
1)评估缓释纳曲酮与安慰剂对酒精使用障碍(AUD)患者饮酒的影响。2)进行预先计划的亚组分析，以检验在开始治疗时戒除(引入戒除)或治疗持续时间是否提高了治疗效果。
设计
报告缓释纳曲酮对酒精消费环境的影响的随机随机安慰剂对照试验的系统回顾和随机效应荟萃分析：门诊诊所参与者：7项试验，共评估1500名患有AUD的成年人，每月接受安慰剂或缓释纳曲酮注射，剂量为150-400 mg，持续2-6个月，并接受某种形式的行为治疗。
测量
每月饮酒天数和每月重度饮酒天数的合并加权平均差(WMD)结果：与安慰剂相比，缓释纳曲酮每月饮酒天数的WMD为-2.0(95%CI，-3.4，-0.6；p=0.03)，重度饮酒天数的WMD为-1.2(95%CI，-0.2，-2.1；p=0.02)，表明与安慰剂相比，治疗组每月饮酒天数减少2天，每月重度饮酒天数减少1.2天。不需要引导戒酒和持续3个月以上的试验报告了每月大量饮酒天数的较大减少，WMD-2.0(95%CI，-3.52，-0.48；p=0.01)和-1.9(95%CI，-3.2，-0.5；p=0.01)。在所有情况下，I2统计数据(0-7.2%)都没有显示出明显的异质性。
结论
与安慰剂相比，缓释纳曲酮每月减少饮酒天数和重度饮酒天数。治疗时间越长，减少的幅度越大。
AIMS
1) Estimate the effect of extended-release naltrexone compared with placebo on alcohol consumption in patients with alcohol use disorder (AUD). 2) Conduct pre-planned subgroup analyses to test whether being abstinent when initiating treatment (lead-in abstinence) or the duration of treatment improves treatment efficacy.
DESIGN
Systematic review and random effects meta-analysis of blinded randomized placebo-controlled trials reporting the effect extended-release naltrexone on alcohol consumption SETTING: Outpatient clinics PARTICIPANTS: 7 trials evaluating a total of 1500 adults with AUD receiving monthly injections of either placebo or extended-release naltrexone at doses of 150-400mg for 2-6 months and some form of behavioral therapy.
MEASUREMENTS
Pooled weighted mean difference (WMD) in drinking days per month and heavy drinking days per month FINDINGS: The WMD was -2.0 (95% CI, -3.4, -0.6; p = 0.03) in favor of extended-release naltrexone for drinking days per month, and -1.2 (95% CI, -0.2, -2.1; p = 0.02) for heavy drinking days per month, indicating that treatment resulted in 2 fewer drinking days per month and 1.2 fewer heavy drinking days per month compared with placebo. Trials not requiring lead-in abstinence and those lasting longer than 3 months reported larger reductions in heavy drinking days per month, WMD -2.0 (95% CI, -3.52, -0.48; p = 0.01) and -1.9 (95% CI, -3.2, -0.5; p = 0.01) respectively. In all cases, the I2 statistics (0-7.2%) did not suggest substantial heterogeneity.
CONCLUSIONS
Extended-release naltrexone reduces drinking days and heavy drinking days per month compared with placebo. Reductions are larger with longer duration of treatment.
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