Preliminary findings on the use of metadoxine for the treatment of alcohol dependence and alcoholic liver disease

Objective Metadoxine is approved in Europe for alcohol intoxication and is also indicated for alcoholic liver disease (ALD). This study aims to investigate the use of metadoxine as a potential pharmacotherapy for alcohol dependence (AD). Methods This is a retrospective study of 94 outpatients with AD, who received metadoxine for alcohol intoxication and were assessed for alcohol consumption, craving [Visual Analog Scale (VAS)] and liver-related and alcohol-related biomarkers [aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl-transpeptidase, mean corpuscular volume]. Results Range of metadoxine dose was 500-2000mg/day, with a mean dose of 1277(s.d.290)mg/day, and for a period of 2-42days, with a mean period of 8.9(s.d.7.0)days. Follow-up data were available for 52 patients (55.3%); 35(67.3%) patients were completely abstinent. There was a significant decrease in drinks per week, even after substituting baseline drinking as follow-up data for dropouts (p<0.001) and examining drinking pre-treatment and post-treatment for those who did not achieve abstinence (p<0.001). There was a significant decrease in the VAS (p<0.001) and a significant improvement in the AST/ALT ratio (p=0.03). Discussion Despite important limitations, this study represents a further preliminary observation suggesting metadoxine as a novel alcohol pharmacotherapy, including in alcohol-dependent patients with ALD.