Apremilast, an FDA-approved medication typically used for psoriasis and psoriatic arthritis, has demonstrated a significant reduction in alcohol consumption in a recent clinical study. The research, conducted at the Scripps Research Institute, indicates that apremilast could offer a novel approach to treating alcohol use disorder.
The double-blind, placebo-controlled study involved 51 participants with alcohol use disorder who were not actively seeking treatment. Over an 11-day period, participants receiving apremilast showed a marked decrease in alcohol intake, reducing their consumption from an average of five drinks per day to two. This substantial reduction has sparked considerable interest among researchers in the field.
Mechanism of Action
Prior to the human study, researchers at OHSU (Oregon Health & Science University) investigated apremilast's effects in animal models with a genetic predisposition for excessive drinking. These studies revealed that apremilast reduced drinking across various models. Further investigation pinpointed the nucleus accumbens, a brain region pivotal in controlling alcohol intake, as the area where apremilast exerted its effects by increasing activity.
Angela Ozburn, Ph.D., associate professor of behavioral neuroscience in the OHSU School of Medicine, noted, "I’ve never seen anything like that before."
Clinical Implications and Future Directions
Barbara Mason, Ph.D., Pearson Family professor at Scripps, highlighted the drug's tolerability and effect size, stating, "Apremilast’s large effect size on reducing drinking, combined with its good tolerability in our participants, suggests it is an excellent candidate for further evaluation as a novel treatment for people with alcohol use disorder."
Researchers believe that apremilast may be even more effective in individuals motivated to reduce their alcohol consumption and are advocating for more clinical trials involving individuals actively seeking treatment. While apremilast is generally well-tolerated, potential side effects such as nausea, diarrhea, and headaches need to be further evaluated with long-term use.
Context within Existing Treatments
Currently, the FDA has approved three medications for alcohol use disorder: Antabuse (disulfiram), acamprosate, and naltrexone. Apremilast offers a different mechanism of action compared to these existing treatments, potentially providing a new avenue for managing alcohol dependence. Bankole Johnson, a neuroscientist and addiction medicine specialist at the University of Maryland School of Medicine, expressed optimism, stating, "It's still early days, but this could be a game-changer for the treatment of alcohol use disorder."
Collaborative Research and the INIA Consortium
The research was facilitated by the INIA-Neuroimmune consortium, which brings together experts in neuroscience, immunology, and pharmacology. This collaborative approach allows for the identification and testing of promising drug candidates in animal models, accelerating the translation of basic science research into improved human health outcomes. Ozburn emphasized the importance of this collaboration, stating, "This collaboration allows us to bring together researchers with different expertise and perspectives to tackle complex problems."
