Baclofen for alcohol use disorder—a systematic meta‐analysis.

Saved in:

Bibliographic Details
Title:	Baclofen for alcohol use disorder—a systematic meta‐analysis.
Authors:	Bschor, T., Henssler, J., Müller, M., Baethge, C.
Source:	Acta Psychiatrica Scandinavica. Sep2018, Vol. 138 Issue 3, p232-242. 11p. 1 Diagram, 3 Charts, 1 Graph.
Subjects:	Alcoholism treatment, Drug efficacy, Baclofen, Alcohol drinking, Heterogeneity, Meta-analysis, Therapeutics
Abstract:	Objective: To evaluate the efficacy and tolerability of baclofen vs. placebo for long‐term treatment of alcohol use disorder. Method: Systematic review and meta‐analysis following methods of the Cochrane Collaboration Handbook (PROSPERO registration: CRD42017073663). Primary outcome was the random‐effects summary estimate of all standardized mean differences (SMDs), as calculated from the primary outcomes of each study. Results: Fourteen double‐blind RCTs (1522 patients) were included. Heterogeneity was substantial for most analyses (I2 about 75%). Baclofen showed a small, but not statistically significant superiority over placebo: SMD = 0.22 ([95% CI: −0.03; 0.47], P = 0.09). This result was supported by a leave‐one‐out‐analysis, and Orwin's fail‐safe N, by predefined secondary analyses (on abstinence rates and amount of drinking), and by a post hoc‐analysis of high‐dose studies (>80 mg/day). An analysis of low risk of bias studies (SMD = 0.10 [−0.20; 0.41], P = 0.51, I2 = 43.3%) found no effect. Exclusion of four studies focusing on patients with comorbidity yielded a small positive effect. Drop‐out rates were similar. Conclusion: Our results question baclofen's utility in the long‐term treatment of alcohol use disorder at both normal and high doses. While the confidence intervals indicate that marginally harmful or moderately beneficial effects of baclofen remain a possibility, the most likely effect size is slightly above placebo effects. [ABSTRACT FROM AUTHOR]
	Copyright of Acta Psychiatrica Scandinavica is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database:	Psychology and Behavioral Sciences Collection

Description
Abstract:	Objective: To evaluate the efficacy and tolerability of baclofen vs. placebo for long‐term treatment of alcohol use disorder. Method: Systematic review and meta‐analysis following methods of the Cochrane Collaboration Handbook (PROSPERO registration: CRD42017073663). Primary outcome was the random‐effects summary estimate of all standardized mean differences (SMDs), as calculated from the primary outcomes of each study. Results: Fourteen double‐blind RCTs (1522 patients) were included. Heterogeneity was substantial for most analyses (I2 about 75%). Baclofen showed a small, but not statistically significant superiority over placebo: SMD = 0.22 ([95% CI: −0.03; 0.47], P = 0.09). This result was supported by a leave‐one‐out‐analysis, and Orwin's fail‐safe N, by predefined secondary analyses (on abstinence rates and amount of drinking), and by a post hoc‐analysis of high‐dose studies (>80 mg/day). An analysis of low risk of bias studies (SMD = 0.10 [−0.20; 0.41], P = 0.51, I2 = 43.3%) found no effect. Exclusion of four studies focusing on patients with comorbidity yielded a small positive effect. Drop‐out rates were similar. Conclusion: Our results question baclofen's utility in the long‐term treatment of alcohol use disorder at both normal and high doses. While the confidence intervals indicate that marginally harmful or moderately beneficial effects of baclofen remain a possibility, the most likely effect size is slightly above placebo effects. [ABSTRACT FROM AUTHOR]
ISSN:	0001690X
DOI:	10.1111/acps.12905