Publication date: Sep 10, 2019
There is a drug, known as acamprosate, that has a low side-effect profile and has been shown to reduce or even completely eliminate cravings for alcohol, but it only works for about 10 percent of patients.
A new large-scale study conducted by researchers at Mayo Clinic and Hazelden Betty Ford Foundation aims to identify biomarkers that would predict patient response to the drug.
That way, doctors could prescribe the medication to the patients with the highest chance of positive response.
Marvin Seppala M. D., Hazelden Betty Ford’s chief medical officer, explained that this research is particularly exciting because AUD directly impacts the lives of millions of people worldwide.
Though the 10 percent success rate of acamprosate, which has been approved for the treatment of AUD and available in the United States since 2004, may seem low, Seppala argues that it still has the potential to help a large number of Americans.
Victor Karpyak M. D., a consultant in Mayo Clinic’s department of psychiatry and the study’s principal investigator, said that acamprosate’s success rate is similar to that of most psychiatric medications.
Seppala told the story of one patient – the first person he witnessed responding to the medication.
The patient’s struggle with AUD was long-lasting and resistant to treatment, Seppala reported.
Though Seppala’s patient had ongoing cravings during the week, she usually stayed away from alcohol while her husband was away.
So many people struggle with the disease of alcoholism; if he could have the opportunity to identify the individuals with AUD who would be best helped by this particular medication, he could see more people achieve a life of sobriety.
-It is hard to convince a patient to try a medication that only works 10 percent of the time,” he said.
-If you don’t know a medication will benefit your patient, you don’t really know anything,” Seppala said.
Naltrexone, a medication that is also used in the treatment of opioid use disorder (OUD), can be used in the to reduce alcohol cravings in the treatment of AUD.
The success rate with this medication hovers around -20-25 percent” for people with AUD, he explained.
Seppala said that he is most likely to prescribe acamprosate to patients as a last-ditch medication.
The medication has to be taken three times a day, which can reduce compliance, especially when patients understand that there is a 90 percent chance the it may not work for them.
Seppala can’t help but think back to his earlier patient who responded so positively to the medication.
By analyzing patient response to the medication, researchers hope to come up with a genetic signature, or a combination of biomarkers that would come together to form a pattern associated with either a positive or negative response to acamprosate, Karpyak said.
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