Effectiveness of baclofen for the treatment of alcohol use disorder in patients with alcoholic liver disease: a narrative literature review
Friday, February 24th, 2023
Available online: 24th February 2023
James Cook University
Background: Alcohol use disorder (AUD) is linked to alcoholic liver disease (ALD), which contributes greatly to the global burden of disease. Baclofen has been studied in patients with these concurrent disorders. However, due to limited research, baclofen is only used off-label.
Aim: To determine the effectiveness of baclofen for the treatment of AUD and ALD.
Methods: MEDLINE, Scopus and The Cochrane Library were searched using the terms [((“alcohol use disorder” OR “alcohol dependence”) AND (“alcoholic liver disease” OR “cirrhosis”)) AND (“baclofen”)]. Additional papers were retrieved from the reference lists of relevant studies.
Results: We identified seventy-one studies and retrieved two from reference searching. Ten studies meeting inclusion and exclusion criteria were retained for review, four of which were randomised controlled trials (RCTs). Retrospective and prospective cohort studies were also included, along with one Markov model. The literature defined baclofen’s effectiveness in terms of abstinence, alcohol consumption, hospitalisations, cost-effectiveness, mortality rates, and side effects. While controlled evidence is limited, baclofen was found to promote abstinence, whilst also reducing drinking levels, long-term mortality, and days spent in hospital. Additionally, the drug had a favourable cost-effectiveness profile. However, acute confusion and overdoses have been reported, particularly with high dosages.
Conclusion: Our findings support the efficacy and use of baclofen to treat AUD and ALD. The risk of serious adverse events remains a concern, requiring vigilant prescribing and reporting from healthcare professionals. RCTs and studies with larger sample sizes are required to support these initial findings and confirm the viability of baclofen.
Keywords: Alcohol use disorder; alcoholic liver disease; baclofen; effectiveness; abstinence