Bschor, T., Henssler, J., Mueller, M. and Baethge, C. (2018). Baclofen for alcohol use disordera systematic meta-analysis. Acta Psychiatr. Scand., 138 (3). S. 232 - 243. HOBOKEN: WILEY. ISSN 1600-0447

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Abstract

ObjectiveTo evaluate the efficacy and tolerability of baclofen vs. placebo for long-term treatment of alcohol use disorder. MethodSystematic 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. ResultsFourteen double-blind RCTs (1522 patients) were included. Heterogeneity was substantial for most analyses (I-2 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 (>80mg/day). An analysis of low risk of bias studies (SMD=0.10 [-0.20; 0.41], P=0.51, I-2=43.3%) found no effect. Exclusion of four studies focusing on patients with comorbidity yielded a small positive effect. Drop-out rates were similar. ConclusionOur 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.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Bschor, T.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Henssler, J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mueller, M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Baethge, C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-175604
DOI: 10.1111/acps.12905
Journal or Publication Title: Acta Psychiatr. Scand.
Volume: 138
Number: 3
Page Range: S. 232 - 243
Date: 2018
Publisher: WILEY
Place of Publication: HOBOKEN
ISSN: 1600-0447
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
HIGH-DOSE BACLOFEN; PRELIMINARY DOUBLE-BLIND; DEPENDENT PATIENTS; EFFICACY; SAFETY; ABSTINENCEMultiple languages
PsychiatryMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/17560

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