Naltrexone for alcohol use disorder: Hepatic safety in patients with and without liver disease

• DOI: 10.1002/hep4.2080
• Publication Date: 2022-10-25T11:59:20Z
• Authors: Divya Ayyala; Thomas Bottyan; Christine Tien; Michael Pimienta; Jennie Yoo; Kelli Stager; Jose Luis Gonzalez; Andrew Stolz; Jennifer L. Dodge; Norah A. Terrault; Hyosun Han
• Keywords: Alcohol use disorder; Liver disease

Naltrexone is an approved drug for management of alcohol use disorder (AUD), but data in patients with liver disease (LD) are limited. We aimed to evaluate the safety naltrexone those LD. This a retrospective cohort adults and without LD who were prescribed AUD from 2015 2019 safety-net setting. hepatic was determined by enzyme changes during after compared before prescription as well rates subsequent hospitalization death Kaplan-Meier methods. Factors associated examined Cox regression. Of 160 AUD, 100 (63%) had 47 (47%) cirrhosis (47% decompensated). The total cohort, LD, groups lower adjusted mean aspartate aminotransferase alanine levels versus (p < 0.001). Two-year survival 97.7% (95% confidence interval [CI], 84.6-99.7), 95.4% CI, 82.8-98.8), 90.8% 73.5-97.0), 81.3% 41.2-93.8) cirrhosis, decompensated = 0.46), respectively. Alcohol-related 2-year 8.2% 2.7-24), 27.7% 16.6-44.0), 40.5% 24.8-61.6), 41.7% 23.3-66.6) 0.007), Independent predictors (hazard ratio [HR], 3.70; 95% 1.19-11.51; p 0.02), (HR, 5.16; 1.69-15.75), shorter duration (≤30 days) 2.50; 1.l2-5.20; 0.01). Conclusion: safe underlying including compensated cirrhosis. Although encouraging, more needed