O2.2the Impact Of Treatment Duration In Alcoholism: An Individual Patient Meta-analysis On Acamprosate Randomized Controlled Trials

Background. Acamprosates effectiveness was demonstrated in controlled trials with different treatment durations varying between 1 and 24 months. So far, the treatment duration was never used as a predictor of therapy success. Our objective was to determine the minimum duration associated with a clinically significant effect. Material. From a Meta-base of 24 randomized controlled studies having included 6423 patients starting the trial with an in-patient detoxification period, we conducted a longitudinal mixed model individual patient meta-analysis, assuming first-order autocorrelation of change in time for drinking amount and continuous abstinence. Results. We observed an overall monthly linear consumption increase of 0.22 drinks (95%CI [.12, .31], p Conclusion. An overall linear mean deterioration of drinking outcomes in time is observed. Acamprosate compensates the deterioration, however a clinically significant effect (defined by relative reduction of at least one drink and relapse rate OR > 1.30) is expected after 6 months treatment, and enhanced at one year. Thus, to ensure clinically relevant drug effects, treatment with acamprosate should be maintained for at least 6 months after alcohol withdrawal.