title: Comparing Nalmefene and Naltrexone in Alcohol Dependence: Are there any Differences? Results from an Indirect Meta-Analysis.
abstract: BACKGROUND
  The mu-opioid antagonist naltrexone is one of the few approved pharmacotherapies for the treatment of alcohol dependence. Recently, the mu-opioid antagonist and partial kappa agonist nalmefene was approved by the European Medicines Agency for the reduction of alcohol consumption in adult patients with alcohol dependence. To date, no head-to-head studies have compared the efficacy and safety of naltrexone and nalmefene in reducing alcohol consumption.
  
  
  METHODS
  An indirect meta-analysis of randomized controlled studies on these 2 medications was conducted. A random effects model was used to measure effects and compare the 2 medications. 4 placebo-controlled studies with nalmefene and 13 with naltrexone were included.
  
  
  RESULTS
  A statistically significant advantage of nalmefene towards naltrexone in the 2 patient-relevant outcome efficacy criteria, quantity and frequency of drinking, was found. Both drugs had a benign safety profile.
  
  
  CONCLUSIONS
  This indirect meta-analysis indicates an advantage of nalmefene over naltrexone. Nalmefene is an effective and well-tolerated medication for the reduction of alcohol consumption. Additional data are necessary to demonstrate possible advantages of nalmefene over naltrexone in the treatment of alcohol dependence.
authors: Department of Psychiatry and Psychotherapy, Ludwig Maximilian University, Munich, Germany.
authors: M
authors: M
authors: Soyka
authors: Lundbeck GmbH, Hamburg, Germany.
authors: M
authors: M
authors: Friede
authors: Institut für angewandte Statistik GmbH, Bielefeld, Germany.
authors: J
authors: J
authors: Schnitker
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000188:drug therapy; D000437:Alcoholism / Q000188:drug therapy*; D006801:Humans; D009271:Naltrexone / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
chemical_list: D009292:Narcotic Antagonists; D009271:Naltrexone; C038981:nalmefene