Treating alcohol use disorder may reduce alcohol-associated liver disease mortality
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LAS VEGAS – Pharmacological treatments of alcohol use disorder have been found to improve mortality outcomes for patients with alcohol-associated liver disease, according to a presenter at the ACG Annual Scientific Meeting.
“Our study found that these medications are underutilized. It is associated with 1-year lower mortality in patients admitted with alcohol-associated liver disease, and we do need further studies to try and increase the utilization of these medications,” Patrick Twohig, MD, MPH, a second-year gastroenterology and hepatology fellow at the University of Nebraska Medical Center, said during his presentation.
“Alcohol use disorder is highly prevalent in society, and its health complications account for significant disease and financial burden in the United States and worldwide,” Twohig told Healio. “Both pharmacologic and behavioral treatments have been shown to be very efficacious in treating alcohol use disorder, but multiple barriers exist in translating these medications into clinical practice, one of which is that providers report a lack of knowledge and education regarding their use. There is a paucity of research surrounding the use of pharmacologic therapies for alcohol use disorder in patients with underlying liver disease.”
In a retrospective cohort study, researchers aimed to quantify the use of alcohol use disorder (AUD) medications in patients admitted with alcohol-associated liver disease (ALD) and to assess mortality outcomes. The study included 115 patients (63% men; mean age, 51.7 years) who had been hospitalized for ALD and AUD between 2018 to 2020 at the University of Nebraska Medical Center. Of the 115 patients, 21% (n = 24) were prescribed varying AUD pharmacological treatments, including acamprosate (n = 10), oral naltrexone (n = 7), baclofen (n = 3), IM naltrexone (n = 2) and disulfiram (n = 2).
Patients who were prescribed medical treatment for AUD had a significantly lower 1-year mortality rate of 4.2% as compared to 20.9% for patients not prescribed medical therapy, which remained statistically significant after an age adjustment (OR = 0.18; 95% CI, 0.01-0.96; P = .04).
“Further subgroup analysis of this population who was prescribed therapy show that individuals who were prescribed treatment were typically at younger age, at 47 years compared to 53 years, were also less likely to have ascites and were more likely to have been seen by an addiction psychiatry specialist,” added Twohig.
“Our findings are consistent with prior studies which have shown that these medical therapies for alcohol use disorder are underutilized, but that they are effective in reducing mortality.”
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Twohig P. Treatment of alcohol use disorder in patients admitted with alcohol-associated liver disease: A retrospective cohort study. Presented at: ACG Annual Scientific Meeting; Oct. 22-27, 2021; Las Vegas (hybrid meeting).
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