Treatment of alcohol use disorders in patients with alcoholic liver disease

Addolorato, Giovanni; Mirijello, Antonio; Barrio, Pablo; Gual, Antoni

doi:10.1016/j.jhep.2016.04.029

Cited by 168 publications

(179 citation statements)

References 136 publications

(175 reference statements)

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“…Treatments for alcoholic hepatitis ( e.g. : prednisone and pentoxifylline) may have limited efficacy(25), which further highlights the critical importance of treating the underlying alcohol use disorder(26). The severity of alcoholic hepatitis can range from mild to severe and can be superimposed on chronic liver disease(27).…”

Section: Clinical Stages Of Alcoholic Liver Diseasementioning

confidence: 99%

“…Although brief interventions are not sufficient by themselves in those with very heavy use or dependence(42), they can reinforce other therapeutic approaches such as compliance to medications(43) and/or referral to treatment programs(44, 45). This approach is typically referred to with the acronym SBIRT: screening, brief intervention and referral to treatment(26, 46). …”

Section: Treatment For Alcohol Use Disorder In Patients With Alcoholimentioning

confidence: 99%

“…There is, however, a lack of formal clinical trials that have tested the role of pharmacotherapies in patients with alcohol use disorder and alcoholic liver disease (26). Although hepatotoxicity with naltrexone is rare(61), naltrexone could induce liver injury and is contraindicated in patients with liver diseases as specified in an FDA ‘‘black box”(26).…”

Section: Treatment For Alcohol Use Disorder In Patients With Alcoholimentioning

confidence: 99%

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Treatment of Alcohol Use Disorder in Patients with Alcoholic Liver Disease

Leggio

Lee

2017

The American Journal of Medicine

133

125

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Alcohol is a leading cause of liver disease worldwide. Although alcohol abstinence is the crucial therapeutic goal for patients with alcoholic liver disease, these patients have less access to psychosocial, behavioral and/or pharmacological treatments for alcohol use disorder. Psychosocial and behavioral therapies include 12-step facilitation, brief interventions, cognitive behavioral therapy, and motivational enhancement therapy. In addition to medications approved by the Food and Drug Administration (FDA) for alcohol use disorder (disulfiram, naltrexone and acamprosate), recent efforts to identify potential new treatments have yielded promising candidate pharmacotherapies. Finally, more efforts are needed to integrate treatments across disciplines toward patient-centered approaches in the management of patients with alcohol use disorder and alcoholic liver disease.

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Section: Clinical Stages Of Alcoholic Liver Diseasementioning

confidence: 99%

Section: Treatment For Alcohol Use Disorder In Patients With Alcoholimentioning

confidence: 99%

Section: Treatment For Alcohol Use Disorder In Patients With Alcoholimentioning

confidence: 99%

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Treatment of Alcohol Use Disorder in Patients with Alcoholic Liver Disease

Leggio

Lee

2017

The American Journal of Medicine

133

125

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“…Oxcarbazepine [35] and baclofen [36] have also shown a low hepatic impact; it is to be noted that the patients were detoxified prior to treatment in the oxcarbazepine study, and patients in the baclofen study drank relatively less at baseline assessment compared to our study cohort. Gabapentin and pregabalin treatment for neuropathic pain has been reported in a few cases to cause liver injury [37, 38]; however, one review concludes it to be safe in mild alcoholic liver disease [39]. In this context quetiapine XR provides therapy in an alcohol-drinking population where hepatic injury is likely, and interaction of the treatment could potentially result in liver injury or exacerbation of ongoing liver injury.…”

Section: Discussionmentioning

confidence: 99%

Safety Assessment of Liver Injury with Quetiapine Fumarate XR Management in Very Heavy Drinking Alcohol-Dependent Patients

et al. 2016

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Background Studies have reported liver injury as a consequence of antipsychotic treatment. Very heavy alcohol drinking (ten or more drinks/day for men and eight for women) also causes liver injury. This study aims to evaluate liver injury with quetiapine extended release (XR) in very heavy drinking alcohol-dependent (AD) patients. Methods Two hundred and eighteen AD patients, 18–65 years of age, received 12 weeks of quetiapine XR or placebo treatment in a dose-escalated manner reaching the full dose of 400 mg/day during week 4. Blood chemistry and hematology were assessed at baseline (W0), post-titration at the end of week 3 (W4), week 8 (W8), and end of week 12 (W13). Patients were further grouped as GR.1 (no liver injury, ALT ≤40) and GR.2 (pre-existing liver injury, ALT >40) within each treatment. Drinking history, fasting blood glucose concentration (FBG), and lipid panel were used as covariates in the analyses. Results Liver injury and total drinks and average drinking measures from the Timeline follow-back questionnaire (TLFB) were highly associated. No significant exacerbation in liver injury was observed in patients treated with quetiapine XR in GR.2. Liver injury as determined by elevated alanine aminotransaminase (ALT) was reported in a few patients in GR.1 who received quetiapine XR; however, the occurrence was low, and the level of liver injury was not significant. FBG and lipid measures showed some elevation, but did not show any significant association with liver injury. Conclusion Quetiapine XR did not show any significant exacerbation of liver injury in very heavy drinking alcohol-dependent patients with pre-existing liver injury. Frequency and severity of new liver injury cases in quetiapine XR-treated patients without any pre-existing liver injury was also low. Study findings support medical management of AD patients with heavy drinking profile using quetiapine XR formulation.

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“…The risk for HCC in decompensated alcoholic cirrhosis is close to 1% per year [3,4]. Alcohol consumption is one of the top five causes of disease and disability in almost all European countries [16]. In the United States, about 50% of liver-related death is attributed by alcohol consumption, accounting for $3 billion annually loss, and is the third leading cause of preventable deaths in the U.S. [17].…”

Section: Epidemiologymentioning

confidence: 99%

Treatment and Prognosis of Hepatitis B Virus Concomitant with Alcoholism

Lin¹,

Lin²,

Yang³

2017

Advances in Treatment of Hepatitis C and B

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Hepatitis B virus (HBV) infection is a global disease worldwide. The Asia-Pacific regionhas a high prevalence of viral hepatitis, and Taiwan is a region of high prevalence of chronic hepatitis B (CHB) with increasing alcoholic liver disease. We have investigated the prognosis and treatment of patients with concomitant hepatitis B virus (HBV) infection and alcoholism. The 10-year cumulative incidence of hepatocellular carcinoma (HCC) is much higher in patients with concomitant alcoholism and HBV infection than in those with alcoholism or HBV infection alone. Treatment with antiviral therapy and abstinence may be started in patients with decompensated cirrhosis and compensated cirrhosis with high HBV DNA. In pre-cirrhotic cases, treatment with antiviral therapy and abstinence may be started in patients with persistently elevated ALT levels and high HBV DNA, and significant fibrosis with minimal elevated or normal ALT levels and mild high HBV DNA. Treatment with antiviral therapy and abstinence reduces the incidence of HCC in patients with concomitant HBV infection and alcoholism. In conclusion, patients with concomitant HBV infection and alcoholism have high incidence of cirrhosis, HCC, and mortality. Treatment with antiviral therapy and abstinence may be started to reduce the incidence of cirrhosis, HCC, and mortality in these patients.

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Treatment of alcohol use disorders in patients with alcoholic liver disease

Cited by 168 publications

References 136 publications

Treatment of Alcohol Use Disorder in Patients with Alcoholic Liver Disease

Treatment of Alcohol Use Disorder in Patients with Alcoholic Liver Disease

Safety Assessment of Liver Injury with Quetiapine Fumarate XR Management in Very Heavy Drinking Alcohol-Dependent Patients

Treatment and Prognosis of Hepatitis B Virus Concomitant with Alcoholism

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