Department of Psychology, University of California at Los Angeles, 1285 Franz Hall, Box 951563, Los Angeles, CA, 90095-1563, USA.
Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, USA.
Psychopharmacology (Berl). 2023 Sep;240(9):1921-1930. doi: 10.1007/s00213-023-06409-4. Epub 2023 Jul 15.
Alcohol administration and cue-reactivity paradigms are frequently used to screen for the initial efficacy of medications for alcohol use disorder (AUD). While medication effects on the primary outcomes for these paradigms are assumed to be qualitatively related, there is a critical lack of quantitative evidence to support this hypothesis.
The study aims to test the relationship between medication effect sizes on subjective response to alcohol administration and medication effect sizes for cue-induced craving to cue exposure, using meta-analysis.
Systematic literature searches were conducted to identify randomized trials, wherein AUD medications were tested using the alcohol administration and/or cue-reactivity paradigms. From these studies, descriptive statistics were collected to compute medication effect sizes on the primary outcomes for each respective paradigm. With medication as the unit of analysis, medication effect sizes in alcohol administration studies were compared with medication effect sizes in cue-reactivity studies using the Williamson-York regression which allows for meta-regression across independent samples.
Medication effect sizes on alcohol-induced stimulation and alcohol-induced craving were not significantly associated with medication effect sizes on cue-induced alcohol craving (k stimulation = 10 medications, [Formula: see text] and k craving = 11 medications, [Formula: see text] (SE = 0.237), [Formula: see text]), respectively. Medication effect sizes on alcohol-induced sedation were significantly associated with medication effects on cue-induced craving (k = 10 medications, [Formula: see text] (SE = 0.258), [Formula: see text]), such that medications that increased alcohol-induced sedation were more likely to reduce cue-induced alcohol craving.
With the exception of alcohol-induced sedation, there is little quantitative evidence of medication effects on subjective response domains measured during alcohol administration parallel medication effects on cue-induced alcohol craving. To provide additional context to the current study, future work should examine whether cue-reactivity findings predict clinical trial outcomes.
酒精给药和线索反应范式常用于筛选酒精使用障碍（AUD）药物的初步疗效。虽然药物对这些范式的主要结局的影响被认为在性质上是相关的，但缺乏支持这一假设的定量证据。
本研究旨在使用荟萃分析检验药物对酒精给药后主观反应的效应大小与药物对线索诱发的酒精渴求反应的效应大小之间的关系。
系统文献检索旨在确定使用酒精给药和/或线索反应范式测试 AUD 药物的随机试验。从这些研究中，收集描述性统计数据以计算每个相关范式的主要结局的药物效应大小。以药物为分析单位，使用威廉姆森-约克回归（Williamson-York regression）比较酒精给药研究中的药物效应大小和线索反应研究中的药物效应大小，该回归允许在独立样本中进行元回归。
酒精引起的刺激和酒精引起的渴求的药物效应大小与线索引起的酒精渴求的药物效应大小无显著相关性（刺激[k=10 种药物，[Formula: see text]；渴求[k=11 种药物，[Formula: see text]）（SE=0.237），[Formula: see text]）。酒精引起的镇静的药物效应大小与线索引起的渴求的药物效应大小显著相关（k=10 种药物，[Formula: see text]（SE=0.258），[Formula: see text]），即增加酒精引起的镇静的药物更有可能减少线索引起的酒精渴求。
除了酒精引起的镇静作用外，药物对酒精给药期间测量的主观反应域的影响与药物对线索引起的酒精渴求的影响之间几乎没有定量证据。为了为当前研究提供更多背景信息，未来的工作应该检查线索反应发现是否可以预测临床试验结果。
