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Using pre\u2010established eligibility criteria, two reviewers independently determined whether abstracts contained evidence of demographic or biological characteristics, i.e. moderators, influencing naltrexone response in alcohol dependence. We assessed each publication for risk of bias and evaluated the strength of the body of evidence for each moderator.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010eight publications (on 20 studies) met criteria for data synthesis. These included 26 publications from 12 randomized, placebo\u2010controlled trials, three non\u2010randomized, non\u2010placebo studies and one randomized, non\u2010placebo study. In addition, there were two publications from pooled analyses of four randomized, placebo\u2010controlled trials. Family history of alcohol problems and the <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>sn40<jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>sp polymorphism of the \u03bc\u2010opioid receptor gene showed a positive association with efficacy in four of five and three of five studies, respectively. Other moderators reported to be associated with efficacy included male sex (two of five studies), pre\u2010treatment drinking (two of two studies) and high craving (two of five studies). However, the overall risk of bias in the published literature is high.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The identification of naltrexone\u2010responsive alcohol\u2010dependent patients is still in development. Studies to date point to two potential moderators\u2014family history and presence of the <jats:styled-content style=\"fixed-case\">OPRM<\/jats:styled-content>1 <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>sn40<jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>sp polymorphism\u2014as having the strongest evidence. However, the data to date is still insufficient to recommend that any moderator be used in determining clinical treatment.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.12557","type":"journal-article","created":{"date-parts":[[2014,3,25]],"date-time":"2014-03-25T05:50:58Z","timestamp":1395726658000},"page":"1274-1284","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":77,"title":["Clinical and biological moderators of response to naltrexone in alcohol dependence: a systematic review of the evidence"],"prefix":"10.1111","volume":"109","author":[{"given":"James C.","family":"Garbutt","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Bowles Center for Alcohol Studies University of North Carolina at Chapel Hill  Chapel Hill NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy M.","family":"Greenblatt","sequence":"additional","affiliation":[{"name":"RTI International  Research Triangle Park NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne L.","family":"West","sequence":"additional","affiliation":[{"name":"RTI International  Research Triangle Park NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura C.","family":"Morgan","sequence":"additional","affiliation":[{"name":"RTI International  Research Triangle Park NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexei","family":"Kampov\u2010Polevoy","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Bowles Center for Alcohol Studies University of North Carolina at Chapel Hill  Chapel Hill NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harmon S.","family":"Jordan","sequence":"additional","affiliation":[{"name":"RTI International  Research Triangle Park NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgiy V.","family":"Bobashev","sequence":"additional","affiliation":[{"name":"RTI International  Research Triangle Park NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,5,23]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.64.7.830"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2011.06.045"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.291.10.1238"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.15288\/jsa.2001.62.211"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2004.00763.x"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.2174\/138161210791516459"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2008.07.018"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1530-0277.2001.tb02356.x"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0376-8716(03)00134-0"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.59.10.877"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2013.1960"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1369-1600.2012.00442.x"},{"key":"e_1_2_6_14_1","unstructured":"ViswanathanM. 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