Baclofen: New Hope for Alcohol Abstinence in Patients with Alcohol- and HCV-related Cirrhosis?
Alcohol use and hepatitis-C virus (HCV) infection, either alone or in combination, account for two-thirds of all liver disease in the Western world. Because alcohol consumption accelerates HCV-related liver fibrosis, no safe level of drinking exists in patients with HCV, and total abstinence is recommended. Baclofen, a GABAB receptor agonist, is a potential therapeutic agent for alcohol dependence. This post-hoc analysis of a positive clinical trial of baclofen for the treatment of alcohol dependence in patients with cirrhosis explored whether the safety and efficacy of baclofen was also evident in a subgroup of patients with HCV. Of 84 patients enrolled in the main trial, 24 had alcohol dependence, HCV infection, and cirrhosis. Of these, 12 patients received baclofen (10 mg orally 3 times per day) and 12 received placebo for 12 weeks.
- Ten patients receiving baclofen, compared with 3 receiving placebo, achieved total alcohol abstinence (p=0.01).
- In the baclofen group, compared with placebo, albumin values increased, and a trend toward reduction in international normalized ratio (INR) levels was demonstrated.
- No patients discontinued baclofen due to side effects.