Utilization of Baclofen in Maintenance of Alcohol Abstinence in Patients with Alcohol Dependence and Alcoholic Hepatitis with or without Cirrhosis

Abstract

Baclofen's safety and efficacy in improving the clinical condition patients with alcoholic liver disease has been supported. Randomized prospective studies with longer duration of baclofen in this population may further optimize its use and corroborate efficacy.

Alcohol abstinence in patients surviving an episode of alcoholic hepatitis: Prediction and impact on long‐term survival

“…According to previous research, alcohol recidivism prevention in patients with cirrhosis caused by ALD depends on multidisciplinary collaboration, including psychological treatment based on cognitive‐behavior therapy (CBT), motivational enhancement therapy (MET), comprehensive medical care (CMC), and pharmacological treatments . In addition, a recent open‐label study using baclofen (a gamma‐aminobutyric acid receptor agonist) seems promising in the prevention of alcohol recidivism of patients with AH . Other psychological treatments (e.g., CBT, MET, CMC, or their combination) have not been prospectively evaluated for abstinence maintenance in the treatment of patients with AH.…”

“…(29)(30)(31)(32) In addition, a recent open-label study using baclofen (a gamma-aminobutyric acid receptor agonist) seems promising in the prevention of alcohol recidivism of patients with AH. (33) Other psychological treatments (e.g., CBT, MET, CMC, or their combination) have not been prospectively evaluated for abstinence maintenance in the treatment of patients with AH. Besides determining the key role of alcohol consumption in the outcome of these patients, our study attempted to identify factors that predict alcohol recidivism.…”

Diagnosis and Treatment of Alcohol‐Associated Liver Diseases: 2019 Practice Guidance From the American Association for the Study of Liver Diseases

“…These agents include gabapentin, baclofen, topiramate, ondansetron, and varenicline . Baclofen, a gamma‐aminobutyric acid–B (GABA‐B) receptor agonist, is the only AUD pharmacotherapy that has been tested in an RCT in patients with AC with AUD as well as in two small, uncontrolled observational studies . In a randomized trial consisting of patients with both compensated and decompensated AC, a 12‐week course of baclofen (10 mg three times daily) resulted in improved rates of total alcohol abstinence and decreased relapse compared with the control during 1 year of observation while exhibiting an acceptable safety profile .…”

Treatment of Alcohol Use Disorder in Patients with Alcoholic Liver Disease

“…However, only baclofen has been formally tested in patients with alcohol use disorder and clinically significant alcoholic liver disease in a randomized controlled trial (62, 63) and in observational studies(64, 65); as such, although further research with baclofen is needed, its potential utility for treatment of alcohol use disorder in hepatology settings has been highlighted(66, 67). Unexplored are the combinations of pharmacotherapies and behavioral treatments and of different medications in patients with alcohol use disorder and alcoholic liver disease.…”