{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T02:27:13Z","timestamp":1771468033430,"version":"3.50.1"},"reference-count":155,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Semin Liver Dis"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:p>Alcohol use disorder (AUD) is one of the main causes of global death and disability. The liver represents the main target of alcohol damage, and alcohol-associated liver disease (ALD) represents the first cause of liver cirrhosis in Western countries. Alcohol abstinence is the main goal of treatment in AUD patients with ALD, as treatments for ALD are less effective when drinking continues. Moreover, the persistence of alcohol consumption is associated with higher mortality, increased need for liver transplantation, and graft loss. The most effective treatment for AUD is the combination of psychosocial interventions, pharmacological therapy, and medical management. However, the effectiveness of these treatments in patients with ALD is doubtful even because AUD patients with ALD are usually excluded from pharmacological trials due to concerns on liver safety. This narrative review will discuss the treatment options for AUD-ALD patients focusing on controversies in pharmacological therapy.<\/jats:p>","DOI":"10.1055\/a-1798-2872","type":"journal-article","created":{"date-parts":[[2022,3,16]],"date-time":"2022-03-16T00:12:57Z","timestamp":1647389577000},"page":"138-150","source":"Crossref","is-referenced-by-count":11,"title":["Treating Alcohol Use Disorder in Patients with Alcohol-Associated Liver Disease: Controversies in Pharmacological Therapy"],"prefix":"10.1055","volume":"42","author":[{"given":"Claudia","family":"Tarli","sequence":"first","affiliation":[{"name":"Internal Medicine and Alcohol Related Disease Unit, Department of Medical and Surgical Sciences, Columbus-Gemelli Hospital, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University of Rome, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Mirijello","sequence":"first","affiliation":[{"name":"Internal Medicine Unit, Department of Medical Sciences, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanni","family":"Addolorato","sequence":"additional","affiliation":[{"name":"Internal Medicine and Alcohol Related Disease Unit, Department of Medical and Surgical Sciences, Columbus-Gemelli Hospital, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University of Rome, Rome, Italy"},{"name":"CEMAD Digestive Disease Center, Department of Medical and Surgical Sciences, Hepatology and Gastroenterology Unit, Catholic University of Rome, l.go Gemelli, Rome, Italy"},{"name":"Internal Medicine Unit, Department of Internal Medicine and Gastroenterology, Columbus-Gemelli Hospital, Fondazione Policlinico Universitario A.Gemelli IRCCS, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2022,6,23]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"1015","DOI":"10.1016\/S0140-6736(18)31310-2","article-title":"Alcohol use and burden for 195 countries and territories, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016","volume":"392","author":"GBD 2016 Alcohol Collaborators","year":"2018","journal-title":"Lancet"},{"issue":"10","key":"ref2","doi-asserted-by":"crossref","first-page":"1574","DOI":"10.14309\/ajg.0000000000000340","article-title":"Alcohol consumption and risk of liver cirrhosis: a systematic review and meta-analysis","volume":"114","author":"M Roerecke","year":"2019","journal-title":"Am J Gastroenterol"},{"issue":"05","key":"ref3","doi-asserted-by":"crossref","first-page":"998","DOI":"10.1016\/j.jhep.2016.06.018","article-title":"Heavy daily alcohol intake at the population level predicts the weight of alcohol in cirrhosis burden worldwide","volume":"65","author":"E Stein","year":"2016","journal-title":"J Hepatol"},{"issue":"12","key":"ref4","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1016\/S2215-0366(18)30337-7","article-title":"The global burden of disease attributable to alcohol and drug use in 195 countries and territories, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016","volume":"5","author":"GBD 2016 Alcohol and Drug Use Collaborators","year":"2018","journal-title":"Lancet Psychiatry"},{"issue":"04","key":"ref5","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1016\/j.jhep.2015.11.006","article-title":"Alcohol and liver disease in Europe \u2013 simple measures have the potential to prevent tens of thousands of premature deaths","volume":"64","author":"N Sheron","year":"2016","journal-title":"J Hepatol"},{"issue":"03","key":"ref6","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1016\/j.jhep.2016.04.029","article-title":"Treatment of alcohol use disorders in patients with alcoholic liver disease","volume":"65","author":"G Addolorato","year":"2016","journal-title":"J Hepatol"},{"issue":"05","key":"ref7","doi-asserted-by":"crossref","first-page":"1464","DOI":"10.1002\/hep.29240","article-title":"Main drivers of outcome differ between short term and long term in severe alcoholic hepatitis: a prospective study","volume":"66","author":"A Louvet","year":"2017","journal-title":"Hepatology"},{"issue":"17","key":"ref8","doi-asserted-by":"crossref","first-page":"1619","DOI":"10.1056\/NEJMoa1412278","article-title":"Prednisolone or pentoxifylline for alcoholic hepatitis","volume":"372","author":"M R Thursz","year":"2015","journal-title":"N Engl J Med"},{"issue":"04","key":"ref9","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1002\/lt.20386","article-title":"Alcohol recidivism impairs long-term patient survival after orthotopic liver transplantation for alcoholic liver disease","volume":"11","author":"A Cuadrado","year":"2005","journal-title":"Liver Transpl"},{"issue":"01","key":"ref10","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1176\/appi.ajp.2017.1750101","article-title":"The American Psychiatric Association Practice Guideline for the pharmacological treatment of patients with alcohol use disorder","volume":"175","author":"V I Reus","year":"2018","journal-title":"Am J Psychiatry"},{"issue":"04","key":"ref11","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1016\/j.dld.2019.12.008","article-title":"Alcohol associated liver disease 2020: a clinical practice guideline by the Italian Association for the Study of the Liver (AISF)","volume":"52","author":"G Addolorato","year":"2020","journal-title":"Dig Liver Dis"},{"key":"ref12","doi-asserted-by":"crossref","DOI":"10.1176\/appi.books.9780890425596","volume-title":"Diagnostic and Statistical Manual of Mental Disorders (5th ed.)","author":"American Psychiatric Association","year":"2013"},{"issue":"04","key":"ref13","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1007\/s40265-015-0358-1","article-title":"Identification and management of alcohol withdrawal syndrome","volume":"75","author":"A Mirijello","year":"2015","journal-title":"Drugs"},{"issue":"06","key":"ref14","doi-asserted-by":"crossref","first-page":"1076","DOI":"10.1093\/eurpub\/ckt016","article-title":"How is alcohol consumption affected if we account for under-reporting? 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