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我们无端为之的事情™:肝病患者酒精使用障碍时避免使用纳曲酮

Things We Do for No Reason™: Avoiding naltrexone for alcohol use disorder in liver disease.

作者信息

Kee Dustin P, Buyske John J, Calcaterra Susan L

机构信息

Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.

Division of Hospital Medicine and Division of General Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.

出版信息

J Hosp Med. 2025 Jul;20(7):768-771. doi: 10.1002/jhm.13569. Epub 2024 Dec 10.

Abstract

Hospitalizations related to alcohol use disorder (AUD) are common. Yet, few patients receive pharmacotherapy consistent with guideline recommendations. Previous concerns over the potential hepatotoxicity of naltrexone have been disproven and recent studies have shown its safety and efficacy in patients with cirrhosis. Naltrexone is an effective therapy to reduce heavy alcohol consumption, however, lack of knowledge among prescribers inhibits greater uptake. Hospitalization is an opportune time for change-naltrexone can promote the reduction or cessation of unhealthy alcohol consumption, as well as subsequent readmissions or progression of alcohol-related liver disease. Hospitalists should stop avoiding naltrexone in the treatment of AUD.

摘要

与酒精使用障碍(AUD)相关的住院情况很常见。然而,很少有患者接受符合指南建议的药物治疗。先前对纳曲酮潜在肝毒性的担忧已被证伪,最近的研究表明其在肝硬化患者中具有安全性和有效性。纳曲酮是减少大量饮酒的有效疗法,然而,开处方者缺乏相关知识阻碍了其更广泛的应用。住院治疗是进行改变的契机——纳曲酮可以促进减少或停止不健康的饮酒行为,以及预防随后的再入院或酒精性肝病的进展。住院医生在治疗AUD时不应再回避使用纳曲酮。

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本文引用的文献

1
Safety of naltrexone in patients with cirrhosis.纳曲酮在肝硬化患者中的安全性。
JHEP Rep. 2024 Apr 10;6(7):101095. doi: 10.1016/j.jhepr.2024.101095. eCollection 2024 Jul.

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