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Article Dans Une Revue Alcohol and Alcoholism Année : 2023

Sodium Oxybate for Alcohol Dependence: A Network Meta-Regression Analysis Considering Population Severity at Baseline and Treatment Duration

1 UvA - University of Amsterdam [Amsterdam] = Universiteit van Amsterdam
2 Unicatt - Università cattolica del Sacro Cuore = Catholic University of the Sacred Heart [Roma]
3 FPUAG - Fondazione Policlinico Universitario A. Gemelli [Rome]
4 CESP - Centre de recherche en épidémiologie et santé des populations
5 Hôpital Paul Brousse
6 DAPP - D&A Pharma Paris - Laboratoires pharmaceutiques
7 GU - Göteborgs Universitet = University of Gothenburg
8 UniFE - Università degli Studi di Ferrara = University of Ferrara
9 UGA UFRM - Université Grenoble Alpes - UFR Médecine
10 CHUGA - Centre Hospitalier Universitaire [CHU Grenoble]
11 Amsterdam Public Health Research Institute [The Netherlands]
12 IDIBAPS - Institut d'Investigacions Biomèdiques August Pi i Sunyer
13 Medizinische Universität Wien = Medical University of Vienna
14 University of Pisa - Università di Pisa
15 Imperial College London
16 CHRU Nancy - Centre Hospitalier Régional Universitaire de Nancy
17 CHU Nîmes - Centre Hospitalier Universitaire de Nîmes
18 CAMH - Centre for Addiction and Mental Health [Toronto]
19 TU Dresden - Technische Universität Dresden = Dresden University of Technology
20 MSMU - I.M. Sechenov First Moscow State Medical University [Moscow, Russia]
21 CRNL - Centre de recherche en neurosciences de Lyon - Lyon Neuroscience Research Center
22 BSC - Bruno Scherrer Conseil [Saint Arnoult en Yvelines]
23 SESSTIM - U1252 INSERM - AMU - UMR 259 IRD - “Cancer, Biomedicine & Society” group
24 Hôpitaux Sud - Hôpital Sainte-Marguerite [CHU - APHM]
25 ATC - Local Health Unit - Addiction Treatment Center [ASL Biella, Italy]
26 Universität Heidelberg [Heidelberg] = Heidelberg University
Philippe Batel
  • Fonction : Auteur
Monique Couderc
  • Fonction : Auteur

Résumé

AIMS: The estimated effect of sodium oxybate (SMO) in the treatment of alcohol dependence is heterogeneous. Population severity and treatment duration have been identified as potential effect modifiers. Population severity distinguishes heavy drinking patients with <14 days of abstinence before treatment initiation (high-severity population) from other patients (mild-severity population). Treatment duration reflects the planned treatment duration. This study aimed to systematically investigate the effect of these potential effect moderators on SMO efficacy in alcohol-dependent patients. METHODS: Network meta-regression allows for testing potential effect modifiers. It was selected to investigate the effect of the above factors on SMO efficacy defined as continuous abstinence (abstinence rate) and the percentage of days abstinent (PDA). Randomized controlled trials for alcohol dependence with at least one SMO group conducted in high-severity and mild-severity populations were assigned to a high-severity and mild-severity group of studies, respectively. RESULTS: Eight studies (1082 patients) were retained: four in the high-severity group and four in the mild-severity group. The high-severity group was associated with larger SMO effect sizes than the mild-severity group: abstinence rate risk ratio (RR) 3.16, P = 0.004; PDA +26.9%, P < 0.001. For PDA, longer treatment duration was associated with larger SMO effect size: +11.3% per extra month, P < 0.001. In the high-severity group, SMO showed benefit: abstinence rate RR 2.91, P = 0.03; PDA +16.9%, P < 0.001. In the mild-severity group, SMO showed benefit only in PDA for longer treatment duration: +23.9%, P < 0.001. CONCLUSIONS: In the retained studies with alcohol-dependent patients, high-severity population and longer treatment duration were associated with larger SMO effect sizes.
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Dates et versions

hal-04068585 , version 1 (05-05-2023)

Identifiants

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Julien Guiraud, Giovanni Addolorato, Henri Jean Aubin, Sylvie Bachelot, Philippe Batel, et al.. Sodium Oxybate for Alcohol Dependence: A Network Meta-Regression Analysis Considering Population Severity at Baseline and Treatment Duration. Alcohol and Alcoholism, 2023, 58 (2), pp.125-133. ⟨10.1093/alcalc/agac070⟩. ⟨hal-04068585⟩
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