Cigarette smoking predicts differential benefit from naltrexone for alcohol dependence.
Cigarette smoking predicts differential benefit from naltrexone for alcohol dependence.
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DOI：
10.1016/j.biopsych.2012.03.023
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发表时间：
2012-11-15
影响因子：
10.6
通讯作者：
O'Malley, Stephanie S.
中科院分区：
文献类型：
--
作者：
Fucito, Lisa M.;Park, Aesoon;Gulliver, Suzy Bird;Mattson, Margaret E.;Gueorguieva, Ralitza V.;O'Malley, Stephanie S.
确定改变酒精依赖药物治疗反应的因素对于治疗计划很重要。一般来说，吸烟预示着更严重的酒精依赖和更差的治疗反应。然而，关于吸烟作为酒精中毒药物治疗不同反应的潜在预测因素的研究有限。我们在 COMBINE 研究中检查了吸烟和饮酒结果之间的关联，这是一项随机、双盲安慰剂对照、为期 16 周的试验，比较了 1383 名酒精依赖个体的药物组合（即阿坎酸和纳曲酮）和行为干预措施（即医疗管理 (MM)、联合行为治疗 (CBI)）。吸烟者（即超过一半的样本）在基线时的几个人口统计和饮酒相关变量上与不吸烟者存在显着差异，并且通常比不吸烟者的治疗结果较差。然而，接受纳曲酮的吸烟者比接受安慰剂的吸烟者有更好的饮酒结果，而非吸烟者的饮酒情况并没有因纳曲酮的分配而变化。这种发现模式的发生与患者是否接受 CBI 还是 MM 无关，并且在控制酗酒类型和基线人口统计学差异后仍然存在。大约 9% 的吸烟者戒烟，另有 10% 在治疗期间减少了香烟摄入量。吸烟的减少并不因治疗分配而异。这些结果表明纳曲酮可能对改善酒精依赖吸烟者的饮酒结果特别有益。 COMBINE 研究，NCT000626，http://www.cscc.unc.edu/combine/。
Identifying factors that modify responsiveness to pharmacotherapies for alcohol dependence is important for treatment planning. Cigarette smoking predicts more severe alcohol dependence and poorer treatment response in general. Nevertheless, there is limited research on cigarette smoking as a potential predictor of differential response to pharmacological treatment of alcoholism. We examined the association between cigarette smoking and drinking outcomes in the COMBINE study, a randomized, double-blind placebo-controlled 16-week trial comparing combinations of medications (i.e., acamprosate and naltrexone) and behavioral interventions (i.e., medical management (MM), combined behavioral therapy (CBI)) in 1383 alcohol dependent individuals. Smokers (i.e., more than half the sample) significantly differed from nonsmokers on several demographic and drinking-related variables at baseline and generally had poorer treatment outcomes than nonsmokers. However, smokers who received naltrexone had better drinking outcomes than smokers who received placebo, whereas alcohol use among nonsmokers did not vary by naltrexone assignment. This pattern of findings occurred independent of whether patients received CBI or MM and remained after controlling for alcoholism typology and baseline demographic differences. Approximately 9% of smokers quit smoking and an additional 10% reduced their cigarette intake during treatment. Reductions in smoking did not vary by treatment assignment. These results suggest that naltrexone may be particularly beneficial for improving alcohol use outcomes in alcohol dependent smokers. The COMBINE Study, NCT000626, http://www.cscc.unc.edu/combine/.
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影响因子：
3.9
作者：
Kiefer, F;Helwig, H;Wiedemann, K
通讯作者：
Wiedemann, K
影响因子：
3.7
作者：
ABRAMS, DB;ROHSENOW, DJ;MONTI, PM
通讯作者：
MONTI, PM
影响因子：
2.9
作者：
Donny, Eric C.;Caggiula, Anthony R.;Weaver, Matthew T.;Levin, Melissa E.;Sved, Alan F.
通讯作者：
Sved, Alan F.
影响因子：
--
作者：
Grant, BF;Hasin, DS;Dawson, DA
通讯作者：
Dawson, DA
影响因子：
--
作者：
Anton, Raymond F.;Oroszi, Gabor;Goldman, David
通讯作者：
Goldman, David