safety & efficacy of baclofen for alcohol withdrawal in chronic liver disease with active alcohol consumption

Conditions: Alcoholic Cirrhosis; Alcohol Abstinence; Alcohol Withdrawal; Medication Toxicity; Medication Adherence

Summary: this study examines the safety and effectiveness of baclofen as a treatment for alcohol withdrawal in patients with chronic liver disease who continue drinking. it aims to evaluate baclofen's ability to promote alcohol abstinence or reduction while monitoring adverse effects. secondary outcomes include liver function changes, hospital readmissions, and complications of cirrhosis. alcohol consumption worsens liver disease prognosis, yet alcohol use disorder (aud) often goes untreated. baclofen, which is safe for patients with liver impairment, is recommended as a first-line treatment for aud in chronic liver disease. this prospective study collects data from patients treated with baclofen at parc taulí hospital, analyzing outcomes at three and six months to assess abstinence, alcohol reduction, and adverse effects.

the medical management of alcohol use disorder (aud) requires a multidisciplinary approach, involving psychiatrists, psychologists, and hepatologists. treatment often combines pharmacotherapy with psychosocial interventions to achieve and maintain abstinence. over the years, various anti-craving medications have been used. due to its renal metabolism, rather than hepatic, baclofen is considered safe for individuals with chronic liver disease and is currently the first-line pharmacological agent for patients with aud and secondary liver disease. despite clinical guidelines recommending baclofen as the preferred medication to reduce alcohol consumption in patients with chronic liver disease, its use remains limited. moreover, no published data or communications exist regarding its application in the investigators specific context. the primary objectives of this study are to assess the rate of abstinence maintenance, evaluate the reported reduction in alcohol consumption, and assess the safety of baclofen as a treatment for alcohol abstinence. the secondary objectives include evaluating changes in liver function related to alcohol abstinence or consumption reduction. liver function will be assessed using the child score (child-turcotte-pugh, ctp) and the meld score (model for end-stage liver disease), both of which are essential tools for predicting prognosis in patients with cirrhosis. treatment initiation may occur across various hospital settings, including inpatient units during hospitalizations, outpatient hepatology services, and psychiatric services. the investigators will evaluate the efficacy and safety of baclofen through regular follow-ups with patients who initiate treatment. data collection methods will include patient interviews, self-reported abstinence, blood tests to assess liver function, and baseline information on active drinking behavior. follow-up will be conducted over a period of six months

Eligibility criteria:
inclusion criteria: * patients with chronic liver disease at any stage * active alcohol consumption * use of baclofen for the treatment of alcohol dependence. exclusion criteria: * severe psychiatric illness requiring other psychotropic pharmacological treatments * organic or functional renal insufficiency

Keywords: alcohol withdrawal baclofen alcoholic cirrhosis alcohol abstinence