Medications for Alcohol Use Disorder Are Increasingly Being Prescribed in American Patients with Advanced Liver Disease.

Abstract

The number of alcohol use disorder patients with mild (n=101) and severe alcoholic liver disease (n=112) increased between 2013 and 2023 (p=0.06). Naltrexone was prescribed in 65%, acamprosate 26% and disulfiram 9%. Internal medicine providers were the most frequent prescribers (51%) followed by Psychiatry (30%), and GI/Hepatology (9%) (p=0.001). Duration of use was longest with naltrexone compared to acamprosate and disulfiram (360 vs 251 vs 190 days, p=0.032). The rate of AUD medication discontinuation for adverse events was similar in both groups (14% vs 12%). Naltrexone, acamprosate, and disulfiram are increasingly being prescribed in American patients with mild and severe ALD with similar tolerability and efficacy.