Nalmefene for the management of alcohol dependence: review on its pharmacology, mechanism of action and meta-analysis on its clinical efficacy

摘要: Nalmefene, a mu- and delta-opioid receptor (MOR, DOR) antagonist partial kappa-opioid (KOR) agonist, is approved in the European Union other countries for reduction of alcohol consumption dependent patients with high drinking risk level according to WHO ("target population"). This review presents an overview nalmefene׳s pharmacology, its mechanisms action meta-analysis on efficacy reducing consumption. The was based systematic search literature. Random effects meta-analyses were performed published unpublished trials directed at using changes heavy days (HDDs) daily total (TAC) from baseline primary endpoint. For each included study dose, Hedges' g used as unbiased estimator standardised mean differences between nalmefene placebo. Preclinical data suggests that counters alcohol-induced dysregulations MOR/endorphine KOR/dynorphin system. Evidence further reduced effective treatment strategy appeals not ready abstinence. Finally, confirmed 20mg HDDs ITT population (Hedge׳s g=-0.20; 95% CI -0.30 -0.09) target g=-0.33; -0.48 -0.18). Similar results seen TAC. Several meta-analyses, including this new meta-analysis, support In conclusion, because it does require abstinence, has potential motivate more thus helps address major public health concern.