利用元回归来测试药物对暗示诱导的渴望的影响是否与临床疗效相关
Steven J Nieto1, Han Du2, Lindsay R Meredith2
1Department of Psychology, University of California at Los Angeles, 1285 Franz Hall, Box 951563, Los Angeles, CA, 90095-1563, USA. snieto@psych.ucla.edu.
Psychopharmacology
|April 13, 2024
概括
在实验室中减少酒精渴望的药物不能预测酒精使用障碍 (AUD) 的现实世界试验的成功. 需要进一步研究AUD药物治疗的早期疗效指标.
科学领域:
- 神经科学是一个神经科学.
- 心理药理学 心理药理学
- 临床心理学 临床心理学
背景情况:
- 酒精暗示暴露范式被广泛用于评估酒精使用障碍 (AUD) 的新疗法.
- 然而,其预测降低酒精消费的临床疗效的能力仍然不确定.
- 这项研究研究了实验室基调诱导的渴望和现实世界治疗结果之间的联系.
研究的目的:
- 确定实验室环境中观察到的药物诱导的酒精渴望减少是否预测AUD随机临床试验 (RCT) 的临床有效性.
- 采用一种新的元分析方法来评估这种预测关系.
主要方法:
- 文献搜索发现了使用酒精暗示反应范式和AUD药物治疗的RCT的研究.
- 计算了提示诱导的渴望 (36项研究,15种药物) 和临床结果 (在139个RCT中大量饮酒和戒酒,19种药物) 的药物效应大小.
- 使用双变量加权最小平方估计和离开一个的交叉验证来分析预测效用.
主要成果:
- 药物对提示诱导的酒精渴望的影响和对重度饮酒的影响之间没有发现显著的关联 (p=0.090).
- 同样,在提示诱导的渴望效应和药物对禁欲的影响之间也没有显著的关系 (p=0.133).
结论:
- 这些发现挑战了酒精暗示反应的有用性,作为AUD药物治疗发展的唯一早期指标.
- 对于新型化合物的II阶段测试,建议使用更广泛的早期疗效指标和实验范式.
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