Does acamprosate improve reduction of drinking as well as aiding abstinence?

Data on patients' alcohol consumption from 15 placebo-controlled treatment studies (n = 3309) were examined to test whether, at a given time point, patients who have taken one or more drinks since the last assessment (‘relapsers', n = 1010) take alcohol on fewer days, report lower average number of drinks per day, and consume less alcohol in total with acamprosate compared to placebo. These studies had varying duration (90 days, 180 days and 360 days). Among relapsers, acamprosate was significantly associated with less quantity (Q) and frequency (F) of drinking compared to placebo in each of the four follow-up periods (p < 0.001). The differences were most marked for the product Q x F (overall weekly consumption). For each period, there were fewer who were drinking an average of five or more drinks per day in the acamprosate compared to the placebo groups. Acamprosate helps reduce the severity of relapse in patients undergoing abstinence-orientated treatment

The DIAGONALE study: A survey designed to analyze the diagnosis and management of goiter in France

Objective: Euthyroid goiter is frequent for general practitioners (GPs) and endocrinologists (ENDOs). It may induce complications especially in elderly subjects when it becomes nodular and hyperfunctional whereas in young subjects prevention of iodine deficiency may prevent this evolution. The primary objective of the observational study diagnosis of iodine deficiency induced goiter and national medical practices (DIAGONALE) was to determine the circumstances of diagnosis of euthyroid goiter, its incidence, the patient characteristics and the management. Methods: A representative sample of GPs and ENDOs working in a private medical practice (exclusively or not) was randomly drawn from a national file without changing the physician-patient relationship. Results: Four hundred and sixty-nine GPs and 195 ENDOs participated in the study. Goiter was diagnosed in 0.86% of patients seen by GPs and 15.7% of patients seen by ENDOs. Pregnant women were mainly and teenagers exclusively seen by ENDOs. The interview and clinical examination were an important time in the management of euthyroid goiter. TSH level was systematically assayed as well as an ultrasonography; 22.6% of GPs did not perform a scintigraphy versus 63.1% of ENDOs. Levothyroxine treatment was frequently prescribed and the objective of TSH levels was 2. mU/L for GPs and 1. mU/L for ENDOs. Conclusion: This observational study showed differences in the management of euthyroid goiter between GPs and ENDOs but also many common practices. It also highlighted a higher incidence rate of goiter in pregnant women and teenagers seen by ENDOs. © 2012 Elsevier Masson SAS

The European NEAT program: an integrated approach using acamprosate and psychosocial support for the prevention of relapse in alcohol-dependent patients with a statistical modeling of therapy success prediction.

Multicenter, prospective study in five European countries to observe outcome in alcohol misusers treated for 24 weeks with acamprosate and various psychosocial support techniques, within the setting of standard patient care. 1289 patients were recruited,543 (42.1%)patients were observed for the full 24-week period. The overall proportion of cumulative abstinence days was 0.48. Multiple physical and psychiatric comorbidities and a history of drug addiction were negatively correlated with outcome, as were, to a lesser extent, multiple previous episodes of detoxification, unemployment, and living alone. Older age and stable employment were positively associated with outcome. The difference in the unadjusted proportion of cumulative abstinence days between countries was significant (p< 0.001). Overall, outcome was not influenced by the nature of the psychosocial support provided. Adverse events were generally mild, with gastrointestinal disorders, which occurred in 21.5% of patients.Multicentre, prospective study dans 5 pays Europeens pour observation de patients alcooliques traités sur 24 semaines avec acamprosate et des psychotherapies variées. 1289 patients ont été recrutés,543 (42.1%)patients ont terminés normalement au bout des 24 semaines. La proportion de cumulative abstinence days CAD fut de 0.48. La difference dans la proportion de CAD ajustée fut significative entre les pays(p< 0.001). Il semble que le devenir ne soit pas dépendant du choix de la psychothérapie

The severity of alcohol dependence does not influence the efficacy of treatment with acamprosate,

Initial severity of the patient before clinical trial is considered as the main predictor of therapy success in alcoholism. This result was found from a Meta-analysis with 4457 patients

Does acamprosate improve control of drinking as well as aiding abstinence ?

Review on literature on the effect of anti-addictive substance in enhancing abstinence of dependent alcoholic patient. published in ALCOHOL. CLIN. EXP. RES.,2002,26.5:84A:475

How effective are biological markers to monitor alcohol consumption in alcoholic patients treated with acamprosate?

In a Randomized Clinical Trial (n=296), Gamma-Gt was found more discriminant than CGT in classifying Alcohol relapse. A linear discriminant combining the two markers is proposed and discussed

The European NEAT program: An integrated approach using acamprosate and psychosocial support for the prevention of relapse in alcohol-dependent patients with a statistical modeling of therapy success prediction

Background: A multicenter, prospective study was conducted in five European countries to observe outcome in alcohol misusers treated for 24 weeks with acamprosate and various psychosocial support techniques, within the setting of standard patient care. Methods: Patients diagnosed as alcohol dependent using DSM-III-R criteria were treated, for 24 weeks, with acamprosate and appropriate psychosocial support. Potential predictor variables were recorded at inclusion. Drinking behavior was monitored throughout; the proportion of cumulative abstinence days was the principal outcome measure. The influence of baseline clinical and demographic variables on outcome was assessed using multiple regression analysis. Adverse events were recorded systematically. Results: A total of 1289 patients were recruited; 1230 took at least one dose of the drug and provided at least one set of follow-up data; 543 (42.1%) patients were observed for the full 24-week period. The overall proportion of cumulative abstinence days was 0.48. Multiple physical and psychiatric comorbidities and a history of drug addiction were negatively correlated with outcome, as were, to a lesser extent, multiple previous episodes of detoxification, unemployment, and living alone. Older age and stable employment were positively associated with outcome. The difference in the unadjusted proportion of cumulative abstinence days between countries was significant (p < 0.001) but less so when adjusted for the predictive factors identified in the multivariate model (p < 0.019). Overall, outcome was not influenced by the nature of the psychosocial support provided. Adverse events were generally mild, with gastrointestinal disorders, which occurred in 21.5% of patients, being the most frequent. Conclusions: This open-label study confirms the efficacy and safety of acamprosate in the treatment of alcohol dependence in the setting of standard patient care. Treatment benefit was observed irrespective of the nature of the psychosocial support provided. Predictors of the response to treatment were identified; their heterogeneous distribution within the study population explained, at least in part, the differences in outcome between countries.SCOPUS: ar.jFLWINinfo:eu-repo/semantics/publishe