| Gender differences in alcohol treatment: an analysis of outcome from the COMBINE study. | |
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MedLine Citation:
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PMID: 20645934 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Relatively few studies have examined gender differences in the effectiveness of specific behavioral or pharmacologic treatment of alcohol dependence. The aim of this study is to assess whether there were gender differences in treatment outcomes for specific behavioral and medication treatments singly or in combination by conducting a secondary analysis of public access data from the national, multisite NIAAA-sponsored COMBINE study. METHODS: The COMBINE study investigated alcohol treatment among 8 groups of patients (378 women, 848 men) who received medical management (MM) with 16 weeks of placebo, naltrexone (100 mg/day), acamprosate (3 g/day), or their combination with or without a specialist-delivered combined behavioral intervention. We examined efficacy measures separately for men and women, followed by an overall analysis that included gender and its interaction with treatment condition in the analyses. These analyses were performed to confirm whether the findings reported in the parent trial were also relevant to women, and to more closely examine secondary outcome variables that were not analyzed previously for gender effects. RESULTS: Compared to men, women reported a later age of onset of alcohol dependence by approximately 3 years, were significantly less likely to have had previous alcohol treatment, and drank fewer drinks per drinking day. Otherwise, there were no baseline gender differences in drinking measures. Outcome analyses of 2 primary (percent days abstinent and time to first heavy drinking day) and 2 secondary (good clinical response and percent heavy drinking days) drinking measures yielded the same overall pattern in each gender as that observed in the parent COMBINE study report. That is, only the naltrexone by behavioral intervention interaction reached or approached significance in women as well as in men. There was a naltrexone main effect that was significant in both men and women in reduction in alcohol craving scores with naltrexone-treated subjects reporting lower craving than placebo-treated subjects. CONCLUSIONS: This gender-focused analysis found that alcohol-dependent women responded to naltrexone with COMBINE's Medical Management, similar to the alcohol-dependent men, on a wide range of outcome measures. These results suggest that clinicians can feel comfortable prescribing naltrexone for alcohol dependence in both men and women. In this study, it is also notable that fewer women than men reported receiving any alcohol treatment prior to entry into the COMBINE study. Of note, women tend to go to primary health care more frequently than to specialty substance abuse programs for treatment, and so the benefit we confirm for women of the naltrexone and MM combination has practical implications for treating alcohol-dependent women. |
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Authors:
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Shelly F Greenfield; Helen M Pettinati; Stephanie O'Malley; Patrick K Randall; Carrie L Randall |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural Date: 2010-07-20 |
Journal Detail:
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Title: Alcoholism, clinical and experimental research Volume: 34 ISSN: 1530-0277 ISO Abbreviation: Alcohol. Clin. Exp. Res. Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-10-06 Completed Date: 2011-02-07 Revised Date: 2012-05-07 |
Medline Journal Info:
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Nlm Unique ID: 7707242 Medline TA: Alcohol Clin Exp Res Country: England |
Other Details:
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Languages: eng Pagination: 1803-12 Citation Subset: IM |
Copyright Information:
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Copyright © 2010 by the Research Society on Alcoholism. |
Affiliation:
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McLean Hospital, 115 Mill Street Belmont, MA 02478, USA. sgreenfield@mclean.harvard.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Alcohol Deterrents / therapeutic use* Alcoholism / drug therapy*, therapy* Behavior Therapy / statistics & numerical data* Combined Modality Therapy / statistics & numerical data Drug Therapy, Combination / statistics & numerical data Female Humans Male Naltrexone / therapeutic use* Narcotic Antagonists / therapeutic use* Randomized Controlled Trials as Topic Sex Characteristics Taurine / analogs & derivatives*, therapeutic use Treatment Outcome |
| Grant Support | |
ID/Acronym/Agency:
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K24 DA019855-01/DA/NIDA NIH HHS; K24 DA019855-02/DA/NIDA NIH HHS; K24 DA019855-03/DA/NIDA NIH HHS; K24 DA019855-04/DA/NIDA NIH HHS; K24 DA019855-05/DA/NIDA NIH HHS; K24 DA019855-06/DA/NIDA NIH HHS; K24DA019855/DA/NIDA NIH HHS; P50 AA010761/AA/NIAAA NIH HHS; U10 AA 117556/AA/NIAAA NIH HHS; U10 AA011756-03/AA/NIAAA NIH HHS; U10 AA011783-03/AA/NIAAA NIH HHS; U10AA011783/AA/NIAAA NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Alcohol Deterrents; 0/Narcotic Antagonists; 107-35-7/Taurine; 16590-41-3/Naltrexone; 77337-76-9/acamprosate |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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