While there has been no new drug against alcoholism since 1995, specialists are awaiting the arrival of three new treatments in the coming years.
“We are living through an absolutely fantastic period in alcoholology. There has been no new drug since 1995, we only had 3 treatments available so far. In 2013, there is finally a 4th who will arrive and 2 others are pushing their noses just behind ”, rejoices Professor Henri-Jean Aubin, addictologist at the Paul Brousse hospital in Villejuif.
Among the three new treatments which are arousing the enthusiasm of specialists, there is of course Baclofen, this muscle relaxant which is already frequently prescribed off-label in the treatment of alcohol dependence. There is no shortage of testimonials from patients “cured” of their alcoholism and even those from doctors who successfully prescribe it. Two clinical trials are currently being carried out in France both in town medicine and in hospitals to validate the efficacy and tolerance of this treatment.
Finally, although less publicized, another drug is also in its last phase of testing in alcohol withdrawal, sodium oxybate, or Alcover. A treatment which has almost the same mechanism of action as that of Baclofen and which suppresses the desire for alcohol.
Listen to Professor Henri-Jean Aubin: “ There is a brain receptor that is particularly sensitive to the effects of alcohol, GABA-B. Baclofen like Alcover stimulates this receptor like alcohol does. “
20 French centers are participating in the clinical evaluation of Alcover, moreover, the addictology service of the Paul Brousse hospital simultaneously participates in research programs on the two drugs. “We are not in a commercial logic of competition, we are testing the two drugs at home. In the end, as a doctor, the more solutions we have, the more therapeutic possibilities we will have to properly help our patients ”, confides Professor Henri-Jean Aubin.
The results of the Alcover study will be known in about a year and a half, but the investigators are already confident enough as they are advancing in known territory. Indeed, this product has already been marketed as an indication for alcohol withdrawal for 15 years in Italy and Austria. Despite this, to validate a European marketing, it is necessary to redo all the efficacy and tolerance studies with current health requirements.
Listen to Professor Henri-Jean Aubin: “If we want marketing authorization on a European scale, we have to redo everything. For example, even if we know that it is effective at 50mg, we must test several doses “
In the 13 comparative studies already published on Alcover, some have shown that it was effective in the context of withdrawal, others also in the prevention of relapse. After 3 months of treatment, this work has shown that the success rate is multiplied by 5 compared to placebo, with relatively few side effects such as dizziness and sometimes gastrointestinal effects such as diarrhea.
In this new impetus for therapeutic research in alcohol dependence, another molecule is even closer to being on the French market. Nalmefene has just obtained its European marketing authorization. Specialists hope that it will be on the French market by the end of 2013 at the latest. It is a product intended for adults dependent on alcohol, with high consumption (> 60g / day for men and> 40 g / day for women), who are not prepared to commit to total abstinence but wish to reduce their consumption.
Listen to Professor Henri-Jean Aubin: “Reduction is a concept that was developed with this drug and which responds to a real demand from 1 in 2 patients. The results are remarkable and the reduction lasts over time. “
Nalmefene is also distinguished from others by its mode of consumption. It is a drug that is taken on demand, that is to say it is taken on an ad hoc basis when the patient knows that he is going to be tempted by alcohol. This can be before a night out, for example for some alcohol addicts who binge drinking only on weekends, as well as for alcoholics who drink more regularly.
Despite all these hopes in the treatment of alcoholism, some specialists are sounding the alarm and recalling that to cure alcohol, it is rare that medical treatment is sufficient. Moreover, the European Medicines Agency has made it clear that for Nalmefene, the prescription should only be done in conjunction with psychosocial support emphasizing compliance and reducing consumption.
Listen to Professor Michel Lejoyeux, addictologist at Bichat hospital: “It’s dangerous to believe that one drug is enough to get out of a behavior. ”
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