Acamprosate Calcium

Scientists believe GLP-1 drugs like Novo Nordisks Ozempic help people with obesity lose weight in part because they can help quell food cravings. Intriguing evidence that these drugs may also help people with alcohol use disorder limit drinking has motivated some doctors to try prescribing GLP-1s for those individuals, too.Controlled clinical trials are now beginning to catch up to clinical practice. A small Phase 2 study published Wednesday in the Journal of the American Medical Association Psychiatry gives some support for this hypothesis. Much of the evidence that has so far been published on alcohol use disorder has relied on animal research or patient records.The JAMA study, by comparison, randomly assigned people with obesity or who were overweight and also had alcohol use disorder to receive either placebo or a low dose of semaglutide, the active drug contained in Ozempic and Wegovy. Researchers then tested how much the drug changed drinking habits after about two months.Using a test in which trial volunteers were offered their preferred beverage to drink over two hours, the study found people who received either semaglutide or placebo drank less during the test at the end of the eight-week treatment period than they did at the beginning. Comparatively, though, study participants on semaglutide drank about 50% less than the people given placebo, as measured by breath alcohol concentration and grams of alcohol consumed.On a weekly basis, semaglutide was associated with a statistical reduction in drinks per drinking day, but not in drinks per calendar day. Treatment didnt seem to affect the number of drinking days versus abstinent days, but reduced participants reported cravings on a questionnaire.The trial, which involved just 48 people, isnt a conclusive verdict on semaglutides efficacy in this setting. And the results are far short of what would be needed for the Food and Drug Administration to formally approve the drugs use in alcohol use disorder. Still, the findings should provide some encouragement to Novo, which has a larger and longer-duration Phase 2 trial testing semaglutide, another obesity drug called cagrilintide and an experimental liver drug on people with alcohol use disorder and liver disease.Separately, Brigham and Womens Hospital in Boston is preparing to recruit volunteers to a trial of tirzepatide, a GLP-1 drug sold by Eli Lilly as Zepbound, in alcohol use disorder. Lillys CEO also said late last year that his company would begin exploring Zebpound as a treatment for alcohol and drug addiction.Reductions in consumption when considered at large scale could lead to improved health outcomes that are not currently appreciated, wrote the study researchers, led by Christian Hendershot, a public health professor at the University of Southern California.Such large-scale improvements in health outcomes were hinted at in a study assessing more than 200,000 patient records in Sweden. That research found people with alcohol or substance use disorders who took semaglutide or an older Novo GLP-1 drug called liraglutide were significantly less likely to have an alcohol or drug-related hospitalization.A larger type of data analysis that pools the results of clinical trials and other types of scientific research, called a meta-analysis, has cast some doubt on the hypothesis, however.The FDA has approved only three drugs to help reduce alcohol consumption: disulfiram in 1951, naltrexone in 1994 and acamprosate in 2004. Lundbeck gained European approval in 2013 for a drug called Selincro that reduced heavy drinking days among people with alcohol dependence. It was never approved in the U.S. for alcohol use disorders, although its active ingredient is approved as a nasal spray and injection to treat opioid overdoses.Semaglutide is approved as Wegovy for obesity and Ozempic for diabetes, while tirzepatide is marketed as Zepbound for obesity and Mounjaro for diabetes. '

▎药明康德内容团队编辑 喝酒伤身，这可不是一句空话。长期大量饮酒可导致酒精使用障碍的发生，患者对酒精使用的控制力削弱，导致生理依赖，耐受性增加以及心理、社会功能和身体的损害。相关研究显示，酒精使用障碍的终生患病率为9%，男性患病率是女性的48倍之多。心理社会支持治疗是酒精使用障碍治疗的基石，药物治疗数据比较有限，但整体也是有效的。既往动物实验发现，胰高血糖素样肽-1受体激动剂（GLP-1 RA）可减少酒精的使用，这提示GLP-1 RA或有潜力作为降低酒精危害的治疗方式。 近日，JAMA Psychiatry发表一项研究，结果以简短报告的形式发布，表明GLP-1 RA中的司美格鲁肽和利拉鲁肽有助于减少酒精使用障碍患者的饮酒量，降低住院风险。 截图来源：JAMA Psychiatry 这是一项观察性研究，纳入年龄16~64岁确诊为酒精使用障碍的患者22万多例，其中63.5%为男性，36.5%为女性，平均年龄40岁。中位随访8.8年间，其中6276例患者使用GLP-1 RA（主要为利拉鲁肽、艾塞那肽、度拉糖肽和司美格鲁肽），7.5万例患者接受酒精使用障碍药物（主要为disulfiram、acamprosate和纳曲酮）治疗。共有13万多（58.5%）的酒精使用障碍患者住院接受治疗。 研究结果显示，接受GLP-1RA治疗的患者中，使用司美格鲁肽的患者风险最低，其中因酒精使用障碍住院风险降低了36%（aHR=0.64，95%CI：0.50~0.83），因任何物质使用障碍（指使用精神活性物质导致的任何精神障碍）住院风险降低了32%（aHR=0.68，95%CI：0.54~0.85）。 其次是利拉鲁肽，其因酒精使用障碍住院风险降低了28%（aHR=0.72，95%CI：0.57~0.92），因任何物质使用障碍住院风险降低了22%（aHR=0.78，95%CI：0.64~0.97）。使用任何治疗酒精使用障碍的药物均可适当降低因酒精使用障碍住院风险和因任何物质使用障碍住院风险。 ▲使用不同药物的患者，因酒精使用障碍住院风险（A）和因任何物质使用障碍住院风险（B）差异（图片来源：参考文献[1]） 此外，研究人员还发现，司美格鲁肽和利拉鲁肽可分别使因躯体症状住院风险降低22%（aHR=0.78，95%CI：0.68~0.90）和21%（aHR=0.79，95%CI：0.69~0.91），但并不能降低患者企图自杀的风险。 研究第一作者兼通讯作者，来自东芬兰大学的Markku Lähteenvuo教授表示：“我们的研究结果表明，GLP-1RA不仅能够治疗糖尿病和肥胖，还可能有助于治疗酒精使用障碍和物质使用障碍，当然，这一发现仍需在随机对照试验中进一步验证”。 点击文末“阅读原文/Read more”，即可访问JAMA Psychiatry官网阅读完整论文。 推荐阅读 欢迎投稿：学术成果、前沿进展、临床干货等主题均可，点此了解投稿详情。 参考资料 [1]Lähteenvuo M, Tiihonen J, Solismaa A, Tanskanen A, Mittendorfer-Rutz E, Taipale H. Repurposing Semaglutide and Liraglutide for Alcohol Use Disorder. JAMA Psychiatry. Published online November 13, 2024. doi:10.1001/jamapsychiatry.2024.3599 [2] 王岚,王冉,王学义.酒精使用障碍的危害及风险[J].神经疾病与精神卫生，2024，22（4）：229-233. [3]University of Eastern Finland. Obesity-fighting drugs may reduce alcohol consumption in individuals with alcohol use disorder.13-Nov-2024.https://www.eurekalert.org/news-releases/1064676 免责声明：药明康德内容团队专注介绍全球生物医药健康研究进展。本文仅作信息交流之目的，文中观点不代表药明康德立场，亦不代表药明康德支持或反对文中观点。本文也不是治疗方案推荐。如需获得治疗方案指导，请前往正规医院就诊。 版权说明：本文来自药明康德内容团队，欢迎个人转发至朋友圈，谢绝媒体或机构未经授权以任何形式转载至其他平台。转载授权请在「医学新视点」微信公众号留言联系。 如有其他合作需求，请联系wuxi_media@wuxiapptec.com 分享，点赞，在看，传递医学新知