Medication effects on cue-induced craving in the human laboratory are associated with return to heavy drinking in randomized clinical trials for alcohol use disorder: A follow-up meta-analysis.

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Τίτλος:	Medication effects on cue-induced craving in the human laboratory are associated with return to heavy drinking in randomized clinical trials for alcohol use disorder: A follow-up meta-analysis.
Συγγραφείς:	Nieto SJ; Department of Psychology, University of California at Los Angeles, Los Angeles, CA, USA.; Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, USA., Du H; Department of Psychology, University of California at Los Angeles, Los Angeles, CA, USA., Meredith LR; Department of Psychology, University of California at Los Angeles, Los Angeles, CA, USA., Donato S; Department of Psychology, University of California at Los Angeles, Los Angeles, CA, USA., Baskerville WA; Department of Psychology, University of California at Los Angeles, Los Angeles, CA, USA., McManus KR; Department of Psychology, University of California at Los Angeles, Los Angeles, CA, USA., Magill M; Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, USA., Ray LA; Department of Psychology, University of California at Los Angeles, Los Angeles, CA, USA.; Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, USA.
Πηγή:	Addiction (Abingdon, England) [Addiction] 2026 Jul; Vol. 121 (7), pp. 1671-1680. Date of Electronic Publication: 2026 Mar 08.
Τύπος έκδοσης:	Journal Article; Meta-Analysis; Review
Γλώσσα:	English
Στοιχεία περιοδικού:	Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 9304118 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1360-0443 (Electronic) Linking ISSN: 09652140 NLM ISO Abbreviation: Addiction Subsets: MEDLINE
Imprint Name(s):	Publication: Oxford : Wiley-Blackwell Original Publication: Abingdon, Oxfordshire, UK : Carfax Pub. Co., c1993-
Ιατρικοί όροι (MeSH):	Alcohol Deterrents/therapeutic use , Alcoholism/drug therapy , Alcoholism/psychology , Craving/drug effects , Cues*, Alcohol Drinking/psychology ; Alcohol Drinking/drug therapy ; Naltrexone/therapeutic use ; Taurine/analogs & derivatives ; Taurine/therapeutic use ; Humans ; Acamprosate ; Follow-Up Studies ; Randomized Controlled Trials as Topic
Περίληψη:	Background and Aims: The alcohol cue-reactivity paradigm is widely used to test the initial efficacy of potential medications for alcohol use disorder (AUD); however, there is limited quantitative evidence demonstrating that medication effects on cue-induced craving are associated with efficacy in clinical trials. This meta-analysis examined whether medication effects on cue-induced alcohol craving are associated with medication effects in randomized clinical trials (RCTs). Methods: Follow-up meta-analysis of RCTs. Participants included people who engaged in heavy drinking or have AUD. Medications were compared with a placebo control. We computed medication effect sizes (Cohen's d) for cue-induced craving (k# of studies = 36 studies; 15 medications) and for the following individual RCT endpoints (k# of studies = 139 studies; 19 medications): percent days abstinent, percent heavy drinking days, the percentage of participants who returned to any drinking, the percentage of participants who returned to heavy drinking, drinks per day and drinks per drinking day. We applied Williamson-York regression models to test the relationship between medication effects on cue-induced craving and the six individual RCT endpoints. One-sided P values were used to test directional hypotheses and two-sided P values were also reported to allow for exploratory interpretation. Results: Medication effect sizes on cue-induced craving were positively associated with medication effect sizes on percent participants who returned to heavy drinking [ INLINEMATH = 1.06, standard error (SE) = 0.63, one-sided P = 0.04, two-sided P = 0.09; k # of effect size = 74; 7 medications] in RCTs but no other RCT endpoints tested. Specifically, medications that reduced cue-induced craving in the human laboratory also decreased the percentage of participants who returned to heavy drinking in RCTs. Conclusions: Medications that produce greater reductions in cue-induced alcohol craving appear to be associated with lower rates of return to heavy drinking, but not consistently with other drinking outcomes. This pattern indicates that the cue-reactivity paradigm has limited and outcome-specific translational validity rather than functioning as a universal indicator of clinical efficacy. (© 2026 Society for the Study of Addiction.)
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Grant Information:	F31AA029295 United States AA NIAAA NIH HHS; F32AA029288 United States AA NIAAA NIH HHS; K24AA025704 United States AA NIAAA NIH HHS; R01AA029701-01S1 United States AA NIAAA NIH HHS; R21AA029771 United States AA NIAAA NIH HHS
Contributed Indexing:	Keywords: alcohol cue‐reactivity; alcohol use disorder; behavioral pharmacology; human laboratory; medications; randomized clinical trials
Substance Nomenclature:	N4K14YGM3J (Acamprosate) 0 (Alcohol Deterrents) 5S6W795CQM (Naltrexone) 1EQV5MLY3D (Taurine)
Entry Date(s):	Date Created: 20260309 Date Completed: 20260624 Latest Revision: 20260626
Update Code:	20260626
DOI:	10.1111/add.70373
PMID:	41797424
Βάση Δεδομένων:	MEDLINE

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ISSN:	1360-0443
DOI:	10.1111/add.70373