Overview
Cirrhosis associated with alcohol use disorder (AUD) is a significant clinical condition where the efficacy and safety of medications for AUD (MAUD) are still being established. Limited evidence exists on the role of these medications in patients with cirrhosis 1.Diagnosis
Management
Medications for alcohol use disorder (MAUD) are associated with a reduced rate of alcohol consumption and increased alcohol abstinence by approximately 32% compared to placebo or standard treatment in patients with AUD and cirrhosis 1.
MAUD evaluated included baclofen, metadoxine, acamprosate, and fecal microbiota transplant 1.
Of serious adverse events in patients treated with MAUD, a small proportion (3%) were possibly or probably related to the study medications 1.Special Populations
Key Recommendations
Medications for alcohol use disorder should be considered to promote abstinence in patients with alcohol-associated cirrhosis 1. (Evidence: Strong)
The efficacy of medications for alcohol use disorder in patients with cirrhosis is supported by meta-analysis of randomized controlled trials and cohort studies 1. (Evidence: Strong)
Medications for alcohol use disorder appear to be safe in patients with cirrhosis, with a low percentage of adverse events related to the medications 1. (Evidence: Moderate)References
1 Gratacós-Ginès J, Bruguera P, Pérez-Guasch M, López-Lazcano A, Borràs R, Hernández-Évole H et al.. Medications for alcohol use disorder promote abstinence in alcohol-associated cirrhosis: Results from a systematic review and meta-analysis. Hepatology (Baltimore, Md.) 2024. link