Cited by 51Alcohol Consumption and Health EffectsSubstance Abuse Treatment and OutcomesAlcoholism and Thiamine Deficiency

Pharmacotherapy for alcoholic patients with alcoholic liver disease

Open access
Vuittonet, Cynthia L., Halse, Michael, Leggio, Lorenzo, Fricchione, Samuel B., Brickley, Michael, Haass-Koffler, Carolina L., Tavares, Tonya, Swift, Robert M. +1 more·2014·American Journal of Health-System Pharmacy

Abstract

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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Registry

Crossref · 10.2146/ajhp140028

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89 of 89 references verified0 citation errors · 0 not checkable

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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].”

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1 retracted

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2 of the 91 references couldn’t be matched to a known paper.

Research works printed but not linked: 1

  1. [66]Haass-Koffler C Leggio L Kenna GA Pharmacological approaches to reducing craving for alcohol in alcohol-dependent patients CNS Drugs In press PMC3990000 24573997

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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
Published
2014-08-01
Volume
71
Issue
15
Pages
1265-1276
ISSN
  • 1079-2082 (ISSN-L)
  • 1535-2900
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
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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