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The More You Take It, the Better It Works: Six-Month Results of a Nalmefene Phase-IV Trial

Background: Alcohol use disorders remain a major health problem. Reduced drinking has been increasingly recognized as a valuable alternative to abstinence. Nalmefene has shown in previous, experimental studies to be a useful tool to aid reduced drinking. However, more data from routine practice sett...

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Autores principales: Barrio, Pablo, Roncero, Carlos, Ortega, Lluisa, Guardia, Josep, Yuguero, Lara, Gual, Antoni
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6518219/
https://www.ncbi.nlm.nih.gov/pubmed/30959893
http://dx.doi.org/10.3390/jcm8040471
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author Barrio, Pablo
Roncero, Carlos
Ortega, Lluisa
Guardia, Josep
Yuguero, Lara
Gual, Antoni
author_facet Barrio, Pablo
Roncero, Carlos
Ortega, Lluisa
Guardia, Josep
Yuguero, Lara
Gual, Antoni
author_sort Barrio, Pablo
collection PubMed
description Background: Alcohol use disorders remain a major health problem. Reduced drinking has been increasingly recognized as a valuable alternative to abstinence. Nalmefene has shown in previous, experimental studies to be a useful tool to aid reduced drinking. However, more data from routine practice settings are needed in order to obtain evidence with high external validity. The aim of this study was to conduct a single-arm phase-IV study with alcohol-dependent outpatients starting with nalmefene for the first time. Here, we present the main effectiveness analysis, scheduled at six months. Methods: This was an observational, multisite, single-arm, phase-IV study conducted among adult alcohol-dependent outpatients who received nalmefene for the first time. The study consisted of four visits: Baseline, 1 month, 6 months, and 12 months. At each visit, drinking variables were obtained from the time-line follow-back regarding the previous month. Satisfaction with medication was also assessed from both patients and professionals with the Medication Satisfaction Questionnaire. A repeated measures mixed model was performed for effective analysis regarding drinking outcomes (reduction in total alcohol consumption and the number of heavy drinking days). Regression analyses were performed in order to find predictors of responses to nalmefene. Results: From a total of 110 patients included, 63 reported data at the six-month visit. On average, patients took nalmefene 69% of days during the month previous to the 6-month assessment. Compared to the one month results, the number of heavy drinking days and total alcohol consumption increased. Still, they were significantly lower than baseline values (outcome evolution over time was from 13.5 to 6.8 to 9.4 days/month, and from 169 to 79 to 116 units/month). A total of 23 patients were considered medication responders. The number of days of taking nalmefene was significantly associated in the regression analysis. Satisfaction was globally high for both professionals and patients and, overall, nalmefene was well-tolerated with no serious adverse events reported. Conclusion: The data provided by this phase-IV study suggest that nalmefene is an effective, well-tolerated treatment for alcohol-dependence in real world, clinical settings.
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spelling pubmed-65182192019-05-31 The More You Take It, the Better It Works: Six-Month Results of a Nalmefene Phase-IV Trial Barrio, Pablo Roncero, Carlos Ortega, Lluisa Guardia, Josep Yuguero, Lara Gual, Antoni J Clin Med Article Background: Alcohol use disorders remain a major health problem. Reduced drinking has been increasingly recognized as a valuable alternative to abstinence. Nalmefene has shown in previous, experimental studies to be a useful tool to aid reduced drinking. However, more data from routine practice settings are needed in order to obtain evidence with high external validity. The aim of this study was to conduct a single-arm phase-IV study with alcohol-dependent outpatients starting with nalmefene for the first time. Here, we present the main effectiveness analysis, scheduled at six months. Methods: This was an observational, multisite, single-arm, phase-IV study conducted among adult alcohol-dependent outpatients who received nalmefene for the first time. The study consisted of four visits: Baseline, 1 month, 6 months, and 12 months. At each visit, drinking variables were obtained from the time-line follow-back regarding the previous month. Satisfaction with medication was also assessed from both patients and professionals with the Medication Satisfaction Questionnaire. A repeated measures mixed model was performed for effective analysis regarding drinking outcomes (reduction in total alcohol consumption and the number of heavy drinking days). Regression analyses were performed in order to find predictors of responses to nalmefene. Results: From a total of 110 patients included, 63 reported data at the six-month visit. On average, patients took nalmefene 69% of days during the month previous to the 6-month assessment. Compared to the one month results, the number of heavy drinking days and total alcohol consumption increased. Still, they were significantly lower than baseline values (outcome evolution over time was from 13.5 to 6.8 to 9.4 days/month, and from 169 to 79 to 116 units/month). A total of 23 patients were considered medication responders. The number of days of taking nalmefene was significantly associated in the regression analysis. Satisfaction was globally high for both professionals and patients and, overall, nalmefene was well-tolerated with no serious adverse events reported. Conclusion: The data provided by this phase-IV study suggest that nalmefene is an effective, well-tolerated treatment for alcohol-dependence in real world, clinical settings. MDPI 2019-04-06 /pmc/articles/PMC6518219/ /pubmed/30959893 http://dx.doi.org/10.3390/jcm8040471 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Barrio, Pablo
Roncero, Carlos
Ortega, Lluisa
Guardia, Josep
Yuguero, Lara
Gual, Antoni
The More You Take It, the Better It Works: Six-Month Results of a Nalmefene Phase-IV Trial
title The More You Take It, the Better It Works: Six-Month Results of a Nalmefene Phase-IV Trial
title_full The More You Take It, the Better It Works: Six-Month Results of a Nalmefene Phase-IV Trial
title_fullStr The More You Take It, the Better It Works: Six-Month Results of a Nalmefene Phase-IV Trial
title_full_unstemmed The More You Take It, the Better It Works: Six-Month Results of a Nalmefene Phase-IV Trial
title_short The More You Take It, the Better It Works: Six-Month Results of a Nalmefene Phase-IV Trial
title_sort more you take it, the better it works: six-month results of a nalmefene phase-iv trial
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6518219/
https://www.ncbi.nlm.nih.gov/pubmed/30959893
http://dx.doi.org/10.3390/jcm8040471
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