Pharmacotherapy for alcoholic patients with alcoholic liver disease
Open accessAbstract
PURPOSE: An update on pharmacotherapy for achieving and maintaining abstinence and mitigating hepatic damage in patients with alcoholic liver disease (ALD) is presented. SUMMARY: Currently there are limited pharmacotherapy options for managing ALD, which encompasses a broad spectrum of disorders ranging from steatosis and alcoholic hepatitis to fibrosis, cirrhosis, and hepatocellular cancer. Individual variation in the severity, presentation, and complex pathologenesis of ALD defines barriers to effective treatment. Scoring of disease severity using validated assessment instruments should guide treatment approaches; abstinence and proper nutrition continue to be the cornerstones of management. A literature search (through December 31, 2013) identified no reports of randomized controlled trials using Food and Drug Administration (FDA)-approved medications for the treatment of alcohol dependence in ALD-spectrum disorders. Disulfiram, acamprosate, and naltrexone (oral and intramuscular), while approved by FDA for treatment of alcohol dependence, are not currently approved for use in patients with ALD. Baclofen (also not FDA-approved for use in ALD) is the only medication available in the United States with demonstrated safety and efficacy in reducing alcoholic behavior that has been formally tested in clinical trials in patients with ALD. Pharmacotherapy of alcoholic hepatitis using glucocorticoids or pentoxifylline has shown promise, but these options are reserved for severe ALD only. CONCLUSION: Although various treatments have been investigated for ALD in patients with alcoholism, complete abstinence from alcohol is currently the only recommended form of hepatoprotection for the entire spectrum of ALD diagnoses.
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There is no effective FDA-approved drug for treating patients with ALD.
“In addition, there is no effective Food and Drug Administration (FDA)-approved drug for treating patients with ALD [24].”
From Pathophysiological Aspects of Alcohol Metabolism in the Liver (2021) · cites this paper as [24]
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- Authors
- Vuittonet, C. L., Halse, M., Leggio, L., Fricchione, S. B., Brickley, M., Haass-Koffler, C. L., Tavares, T., Swift, R. M., & Kenna, G. A.
- Affiliations
- Brown University (US)
- South County Hospital (US)
- South County Hospital, Wakefield, RI.
- National Institutes of Health (US)
- Corresponding author
- Kenna, George A.
- Venue
- American Journal of Health-System Pharmacy
- Publisher
- Oxford University Press (OUP)
- Published
- 2014-08-01
- Volume
- 71
- Issue
- 15
- Pages
- 1265-1276
- ISSN
- 1079-2082 (ISSN-L)
- 1535-2900
- PMC
- PMC4170837
- OpenAlex
- W1967747608
- Cited by
- 51
- References
- 91
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 2 · 2023: 1 · 2022: 8 · 2021: 7 · 2020: 6 · 2019: 4 · 2018: 7 · 2017: 3 · 2016: 4 · 2015: 4 · 2014: 1
- FWCI
- 0.57
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Health-System Pharmacy (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Alcohol Abuse and Alcoholism (R01AA015753, K01AA023867, R03AA020169, R21AA019994, R01AA016079, R21AA021128, R21AA019709)
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Neurology › Alcoholism and Thiamine Deficiency
- Keywords
- alcoholic liver disease, pharmacotherapy, alcoholism, abstinence, disulfiram, acamprosate, naltrexone, baclofen, alcoholic hepatitis, glucocorticoids, pentoxifylline, hepatoprotection, steatosis, liver cirrhosis, hepatocellular carcinoma, disease severity assessment, nutrition
- MeSH terms
- Alcoholism, Humans, Liver Diseases, Alcoholic, Nutritional Support
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