Bloom Benedict T, Bushell Mary-Jessimine
Faculty of Health, University of Canberra, Canberra 2617, Australia.
Vaccines (Basel). 2022 May 27;10(6):860. doi: 10.3390/vaccines10060860.
Drug abuse is a worldwide problem that is detrimental to public health. The potential for drug abuse extends to both legal and illicit drugs. Drawbacks associated with current treatments include limited effectiveness, potential side effects and, in some instances, the absence of or concerns with approved therapy options. A significant amount of clinical research has been conducted investigating immunotherapy as a treatment option against drug abuse. Vaccines against drug abuse have been the main area of research, and are the focus of this review.
An extensive search using "EBSCOhost (Multiple database collection)" with all 28 databases enabled (including "Academic Search Ultimate", "CINAHL Plus with Full Text", and MEDLINE), interrogation of the ClinicalTrials.gov website, and searches of individual clinical trial registration numbers, was performed in February and March of 2022. This search extended to references within the obtained articles.
A total of 23 registered clinical trials for treating drug abuse were identified: 15 for treatment of nicotine abuse (all vaccine-based trials), 6 against cocaine abuse (4 were vaccine-based trials and 2 were metabolic-enzyme-based trials), 1 against methamphetamine abuse (a monoclonal-antibody-based trial), and 1 multivalent opioid treatment (vaccine-based trial). As indicated on the ClinicalTrials.gov website (Home-ClinicalTrials.gov), the status of all but two of these trials was "Completed". Phase 3 clinical trials were completed for vaccine treatments against nicotine and cocaine abuse only.
Evidence in the form of efficacy data indicates that vaccines are not an option for treating nicotine or cocaine abuse. Efficacy data are yet to be obtained through completion of clinical trials for vaccines against opioid abuse. These findings align with the absence of regulatory approval for any of these treatments. This review further highlights the need for novel treatment strategies in instances where patients do not respond to current treatments, and while the search for efficacious vaccine-based treatments continues.
药物滥用是一个全球性问题，对公众健康有害。药物滥用的可能性涵盖合法药物和非法药物。当前治疗方法的缺点包括疗效有限、潜在副作用，在某些情况下，还存在缺乏批准的治疗方案或对其存在担忧的问题。已经开展了大量临床研究，将免疫疗法作为对抗药物滥用的一种治疗选择。抗药物滥用疫苗一直是主要研究领域，也是本综述的重点。
2022年2月和3月，使用启用了全部28个数据库的“EBSCOhost（多数据库集合）”进行了广泛检索（包括“学术搜索终极版”、“全文版护理学与健康领域数据库”和MEDLINE），查询了ClinicalTrials.gov网站，并搜索了各个临床试验注册号。该检索扩展到了所获文章中的参考文献。
共识别出23项治疗药物滥用的注册临床试验：15项用于治疗尼古丁滥用（均为基于疫苗的试验），6项用于对抗可卡因滥用（4项为基于疫苗的试验，2项为基于代谢酶的试验），1项用于对抗甲基苯丙胺滥用（一项基于单克隆抗体的试验），以及1项多价阿片类药物治疗（基于疫苗的试验）。如ClinicalTrials.gov网站（主页 - ClinicalTrials.gov）所示，除两项试验外，所有这些试验的状态均为“已完成”。仅针对尼古丁和可卡因滥用的疫苗治疗完成了3期临床试验。
疗效数据形式的证据表明，疫苗不是治疗尼古丁或可卡因滥用的选择。针对阿片类药物滥用疫苗的临床试验尚未完成，因此尚未获得疗效数据。这些发现与这些治疗方法均未获得监管批准一致。本综述进一步强调，在患者对当前治疗无反应的情况下，需要新的治疗策略，同时对基于疫苗的有效治疗方法的探索仍在继续。
