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Efficacy of as-needed nalmefene in alcohol-dependent patients with at least a high drinking risk level

Wim van den Brink, Henri-Jean Aubin, Anna Bladström, Lars Torup, Antoni Gual, Karl Mann

Alcohol and Alcoholism 2013, Volume 48, pages 570–578

Editor's comment:
The authors investigated the efficacy and safety of as-needed use of nalmefene 18 mg versus placebo in reducing alcohol consumption in a subgroup of patients with at least a high drinking risk level at both screening and randomization from the two randomized controlled 6-month studies ESENSE 1 and ESENSE 2. All the patients also received a motivational and adherence-enhancing intervention. Findings from this post hoc analysis include a superior effect of nalmefene compared with placebo in reducing the number of heavy drinking days and total alcohol consumption at Month 6. Improvements in clinical status and liver parameters were greater in the nalmefene group compared with the placebo group. Adverse events and adverse events leading to dropout were more common with nalmefene than placebo. Based on this post hoc analysis, the authors conclude that nalmefene as-needed should be offered to those alcohol-dependent patients in primary care and outpatient addiction treatment services who are not able to reduce their alcohol consumption following an initial assessment or brief intervention. 

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