Baclofen shows promise for alcoholics with liver disease
Baclofen can reduce drinking in alcoholic patients with cirrhosis of the liver, a study published in The
Lancet last week suggests (2007;370:1915).
Preclinical experiments suggested that baclofen reduces alcohol craving
and enhances abstinence in alcohol-dependent patients. Researchers therefore
examined the impact of baclofen on alcohol abstinence in patients with
liver cirrhosis.
Alcohol-dependent patients with liver cirrhosis are usually excluded
from trials of anticraving drugs because of concerns that such treatments
might worsen liver disease. However, the safety profile of baclofen,
which is mainly excreted unmodified by the kidney, means that it could
be tested on these patients.
For 12 weeks, 84 alcohol-dependent patients with liver cirrhosis received
either oral baclofen or placebo. At the end of the study, 71 per cent
of patients, allocated baclofen, self-reported achieving and maintaining
abstinence, compared with 29 per cent of those assigned to placebo. Patients
taking baclofen achieved abstinence for an average cumulative duration
of 62.8 days, compared with 30.8 days for those receiving placebo.
This reduction in self-reported alcohol use was associated with significant
reductions in clinical markers of liver injury.
The authors suggest that baclofen could have a role in reducing the risk
of recurrent alcohol abuse in patients who have undergone liver transplantation.
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The
Pharmaceutical Journal
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