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长效纳曲酮注射剂治疗酒精使用障碍的疗效:系统评价。

Efficacy of Extended-Release Injectable Naltrexone on Alcohol Use Disorder Treatment: A Systematic Review.

机构信息

School of Public Health, University of Memphis, Memphis, TN, USA.

School of Communication Studies, Kent State University at Stark, North Canton, OH, USA.

出版信息

J Psychoactive Drugs. 2023 Apr-Jun;55(2):233-245. doi: 10.1080/02791072.2022.2073300. Epub 2022 May 28.

Abstract

Alcohol use disorder (AUD) is a serious public health problem. Over 3.3 million people worldwide die each year due to alcohol-related causes, which is almost 5.3% of all deaths. This systematic review examines the effectiveness of injectable naltrexone treatment for people with AUD based on randomized clinical trial studies conducted between January 2004 and December 2019. Following PRISMA-P, this review searched PubMed, PsycINFO, CINAHL, Cochrane Library, and Web of Science for relevant studies. The inclusion criteria were AUD treatment, injectable naltrexone, and randomized clinical trials. Only articles written in English, involving human participants, and published in peer-reviewed journals were considered for this review. A total of 11 studies met the inclusion criteria. Ten out of the 11 studies assessed the impact of injectable naltrexone in a 3- to 6-month follow-up period, with one study having a year follow-up. This systematic review indicates that overall, injectable naltrexone therapy produced positive AUD treatment outcomes, including reduced mean time to first drinking day and/or heavy drinking day, decreased number of drinking and/or heavy drinking days, and increased abstinence, frequently at a statistically significant level in the larger studies. However, in all studies, less than half of the participants were completely abstinent after receiving injectable naltrexone. Injectable naltrexone treatment along with psychosocial therapy holds promise for addressing AUD.

摘要

酒精使用障碍(AUD)是一个严重的公共卫生问题。全球每年有超过 330 万人因酒精相关原因死亡,占所有死亡人数的近 5.3%。本系统评价基于 2004 年 1 月至 2019 年 12 月期间进行的随机临床试验研究,考察了注射用纳曲酮治疗 AUD 的效果。本研究按照 PRISMA-P 指南进行检索,检索了 PubMed、PsycINFO、CINAHL、Cochrane Library 和 Web of Science 中相关研究。纳入标准为 AUD 治疗、注射用纳曲酮和随机临床试验。仅纳入英语发表、涉及人类参与者且发表在同行评议期刊上的文章。共有 11 项研究符合纳入标准。11 项研究中有 10 项评估了 3 至 6 个月随访期内注射用纳曲酮的影响,其中 1 项研究的随访时间为 1 年。本系统评价表明,总体而言,注射用纳曲酮治疗可产生积极的 AUD 治疗效果,包括减少首次饮酒日和/或重度饮酒日的平均时间、减少饮酒日和/或重度饮酒日的次数以及增加戒酒率,在较大的研究中通常具有统计学意义。然而,在所有研究中,接受注射用纳曲酮治疗后,只有不到一半的参与者完全戒酒。注射用纳曲酮联合心理社会治疗有望解决 AUD 问题。

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