TY - JOUR
T1 - Sodium Oxybate for Alcohol Dependence
T2 - A Network Meta-Regression Analysis Considering Population Severity at Baseline and Treatment Duration
AU - Guiraud, Julien
AU - Addolorato, Giovanni
AU - Aubin, Henri-Jean
AU - Bachelot, Sylvie
AU - Batel, Philippe
AU - de Bejczy, Andrea
AU - Benyamina, Amine
AU - Caputo, Fabio
AU - Couderc, Monique
AU - Dematteis, Maurice
AU - Goudriaan, Anna E.
AU - Gual, Antoni
AU - Lecoustey, Sylvie
AU - Lesch, Otto-Michael
AU - Maremmani, Icro
AU - Nutt, David J.
AU - Paille, François
AU - Perney, Pascal
AU - Rehm, J. rgen
AU - Rolland, Benjamin
AU - Scherrer, Bruno
AU - Simon, Nicolas
AU - Söderpalm, Bo
AU - Somaini, Lorenzo
AU - Sommer, Wolfgang H.
AU - Spanagel, Rainer
AU - Walter, Henriette
AU - van den Brink, Wim
N1 - Publisher Copyright: © The Author(s) 2023. Medical Council on Alcohol and Oxford University Press.
PY - 2023/3/10
Y1 - 2023/3/10
N2 - AIMS: The estimated effect of sodium oxybate (SMO) in the treatment of alcohol dependence is heterogeneous. Population severity and treatment duration have been identified as potential effect modifiers. Population severity distinguishes heavy drinking patients with <14 days of abstinence before treatment initiation (high-severity population) from other patients (mild-severity population). Treatment duration reflects the planned treatment duration. This study aimed to systematically investigate the effect of these potential effect moderators on SMO efficacy in alcohol-dependent patients. METHODS: Network meta-regression allows for testing potential effect modifiers. It was selected to investigate the effect of the above factors on SMO efficacy defined as continuous abstinence (abstinence rate) and the percentage of days abstinent (PDA). Randomized controlled trials for alcohol dependence with at least one SMO group conducted in high-severity and mild-severity populations were assigned to a high-severity and mild-severity group of studies, respectively. RESULTS: Eight studies (1082 patients) were retained: four in the high-severity group and four in the mild-severity group. The high-severity group was associated with larger SMO effect sizes than the mild-severity group: abstinence rate risk ratio (RR) 3.16, P = 0.004; PDA +26.9%, P < 0.001. For PDA, longer treatment duration was associated with larger SMO effect size: +11.3% per extra month, P < 0.001. In the high-severity group, SMO showed benefit: abstinence rate RR 2.91, P = 0.03; PDA +16.9%, P < 0.001. In the mild-severity group, SMO showed benefit only in PDA for longer treatment duration: +23.9%, P < 0.001. CONCLUSIONS: In the retained studies with alcohol-dependent patients, high-severity population and longer treatment duration were associated with larger SMO effect sizes.
AB - AIMS: The estimated effect of sodium oxybate (SMO) in the treatment of alcohol dependence is heterogeneous. Population severity and treatment duration have been identified as potential effect modifiers. Population severity distinguishes heavy drinking patients with <14 days of abstinence before treatment initiation (high-severity population) from other patients (mild-severity population). Treatment duration reflects the planned treatment duration. This study aimed to systematically investigate the effect of these potential effect moderators on SMO efficacy in alcohol-dependent patients. METHODS: Network meta-regression allows for testing potential effect modifiers. It was selected to investigate the effect of the above factors on SMO efficacy defined as continuous abstinence (abstinence rate) and the percentage of days abstinent (PDA). Randomized controlled trials for alcohol dependence with at least one SMO group conducted in high-severity and mild-severity populations were assigned to a high-severity and mild-severity group of studies, respectively. RESULTS: Eight studies (1082 patients) were retained: four in the high-severity group and four in the mild-severity group. The high-severity group was associated with larger SMO effect sizes than the mild-severity group: abstinence rate risk ratio (RR) 3.16, P = 0.004; PDA +26.9%, P < 0.001. For PDA, longer treatment duration was associated with larger SMO effect size: +11.3% per extra month, P < 0.001. In the high-severity group, SMO showed benefit: abstinence rate RR 2.91, P = 0.03; PDA +16.9%, P < 0.001. In the mild-severity group, SMO showed benefit only in PDA for longer treatment duration: +23.9%, P < 0.001. CONCLUSIONS: In the retained studies with alcohol-dependent patients, high-severity population and longer treatment duration were associated with larger SMO effect sizes.
UR - http://www.scopus.com/inward/record.url?scp=85150079358&partnerID=8YFLogxK
U2 - https://doi.org/10.1093/alcalc/agac070
DO - https://doi.org/10.1093/alcalc/agac070
M3 - Article
C2 - 36617267
SN - 0735-0414
VL - 58
SP - 125
EP - 133
JO - Alcohol and alcoholism (Oxford, Oxfordshire)
JF - Alcohol and alcoholism (Oxford, Oxfordshire)
IS - 2
ER -