Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
Mental Illness Research, Education and Clinical Center of the Veterans Integrated Service Network 4, Crescenz Veterans Affairs Medical Center, Philadelphia, PA, USA.
Addiction. 2019 Sep;114(9):1547-1555. doi: 10.1111/add.14655. Epub 2019 Jun 5.
Studies of the efficacy of gabapentin for treating alcohol use disorder (AUD) have yielded mixed findings. The aims of our study were to estimate gabapentin's effects on six alcohol-related outcomes, test potential moderators, examine publication bias and evaluate the quality of the studies.
Meta-analysis of placebo-controlled randomized controlled trials (RCTs). Using PubMed and ClinicalTrials.gov, we selected RCTs of gabapentin's effects on alcohol consumption or a biochemical correlate of it, excluding studies limited to other primary outcomes or that combined gabapentin with other medications. We assessed study quality and used a random-effects model to analyze each outcome measure and the Egger regression test and funnel plots to assess publication bias.
We identified seven RCTs of gabapentin that met study criteria. The quality of the studies overall was good, and there was no evidence of publication bias. Four to seven studies contributed to the analysis of the six outcome measures. For all outcome measures the effect estimates were in a direction that favored gabapentin over placebo. However, only for percentage of heavy drinking days was there good evidence of a benefit (g = -0.64, 95% confidence interval = -1.22 to -0.06).
Although gabapentin appears to be more efficacious than placebo in treating AUD, the only measure on which the analysis clearly favors the active medication is percentage of heavy drinking days. Additional studies are needed to define more clearly the role of gabapentin in AUD treatment.
研究加巴喷丁治疗酒精使用障碍(AUD)的疗效得出的结果喜忧参半。我们的研究目的是评估加巴喷丁对六种与酒精相关结局的影响,检验潜在的调节因素,检查发表偏倚,并评估研究质量。
对安慰剂对照随机对照试验(RCT)进行荟萃分析。我们通过 PubMed 和 ClinicalTrials.gov 筛选了评估加巴喷丁对酒精消耗或其生化相关指标影响的 RCT,排除仅关注其他主要结局或联合使用加巴喷丁与其他药物的研究。我们评估了研究质量,并使用随机效应模型分析了每种结局测量值,采用 Egger 回归检验和漏斗图评估发表偏倚。
我们确定了符合研究标准的七项加巴喷丁 RCT。总体而言,研究质量良好,且没有发表偏倚的证据。六项结局测量值的分析有四到七项研究提供了数据。对于所有结局测量值,加巴喷丁的效果估计都倾向于优于安慰剂。然而,只有重度饮酒天数的获益有较好的证据支持(g=-0.64,95%置信区间-1.22 至-0.06)。
尽管加巴喷丁在治疗 AUD 方面似乎比安慰剂更有效,但仅有一项测量指标明确支持活性药物的优势,即重度饮酒天数。需要进一步的研究来更明确地确定加巴喷丁在 AUD 治疗中的作用。