{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T17:40:15Z","timestamp":1787593215130,"version":"build-2736575974"},"reference-count":33,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2021,1,14]],"date-time":"2021-01-14T00:00:00Z","timestamp":1610582400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2021,1,14]],"date-time":"2021-01-14T00:00:00Z","timestamp":1610582400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and aim<\/jats:title>\n                    <jats:p>Pharmacotherapy for alcohol use disorder (AUD) is recommendable, but under\u2010used, possibly due to deficient knowledge of medications. This study aimed to investigate the real\u2010world effectiveness of approved pharmacological treatments (disulfiram, acamprosate, naltrexone and nalmefene) of AUD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A nation\u2010wide, register\u2010based cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Sweden.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>\n                      All residents aged 16\u201364\u00a0years living in Sweden with registered first\u2010time treatment contact due to AUD from July 2006 to December 2016 (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0125\u2009556, 62.5% men) were identified from nation\u2010wide registers.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>The main outcome was hospitalization due to AUD. The secondary outcomes were hospitalization due to any cause, alcohol\u2010related somatic causes, as well as work disability (sickness absence or disability pension), and death. Mortality was analysed with between\u2010individual analysis using a traditional multivariate\u2010adjusted Cox hazards regression model. Recurrent outcomes, such as hospitalization\u2010based events and work disability, were analysed with within\u2010individual analyses to eliminate selection bias.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>Naltrexone combined with acamprosate [hazard ratio (HR)\u00a0=\u00a00.74; 95% confidence interval (CI)\u00a0=\u00a00.61\u20130.89], combined with disulfiram (HR\u00a0=\u00a00.76, 95% CI\u00a0=\u00a00.60\u20130.96) and as monotherapy (HR\u00a0=\u00a00.89, 95% CI\u00a0=\u00a00.81\u20130.97) was associated with a significantly lower risk of AUD\u2010hospitalization compared with no use of AUD medication. Similar results were found for risk of hospitalization due to any cause. Benzodiazepine use and acamprosate monotherapy were associated with an increased risk of AUD\u2010hospitalization (HR\u00a0=\u00a01.18, 95% CI\u00a0=\u00a01.14\u20131.22 and HR\u00a0=\u00a01.10, 95% CI\u00a0=\u00a01.04\u20131.17, respectively). No statistically significant effects were found for work disability or mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Naltrexone as monotherapy and when combined with disulfiram and acamprosate appears to be associated with lower risk of hospitalization due to any and alcohol\u2010related causes, compared with no use of alcohol use disorder (AUD) medication. Acamprosate monotherapy and benzodiazepine use appear to be associated with increased risk of AUD\u2010associated hospitalization.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/add.15384","type":"journal-article","created":{"date-parts":[[2021,1,4]],"date-time":"2021-01-04T13:42:27Z","timestamp":1609767747000},"page":"1990-1998","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Real\u2010world effectiveness of pharmacological treatments of alcohol use disorders in a Swedish nation\u2010wide cohort of 125\u2009556 patients"],"prefix":"10.1111","volume":"116","author":[{"given":"Milja","family":"Heikkinen","sequence":"first","affiliation":[{"name":"Department of Forensic Psychiatry University of Eastern Finland, Niuvanniemi Hospital  Kuopio Finland"},{"name":"Department of Clinical Neuroscience, Division of Insurance Medicine Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidi","family":"Taipale","sequence":"additional","affiliation":[{"name":"Department of Forensic Psychiatry University of Eastern Finland, Niuvanniemi Hospital  Kuopio Finland"},{"name":"Department of Clinical Neuroscience, Division of Insurance Medicine Karolinska Institutet  Stockholm Sweden"},{"name":"School of Pharmacy University of Eastern Finland  Kuopio Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antti","family":"Tanskanen","sequence":"additional","affiliation":[{"name":"Department of Forensic Psychiatry University of Eastern Finland, Niuvanniemi Hospital  Kuopio Finland"},{"name":"Department of Clinical Neuroscience, Division of Insurance Medicine Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellenor","family":"Mittendorfer\u2010Rutz","sequence":"additional","affiliation":[{"name":"Department of Clinical Neuroscience, Division of Insurance Medicine Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markku","family":"L\u00e4hteenvuo","sequence":"additional","affiliation":[{"name":"Department of Forensic Psychiatry University of Eastern Finland, Niuvanniemi Hospital  Kuopio Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jari","family":"Tiihonen","sequence":"additional","affiliation":[{"name":"Department of Forensic Psychiatry University of Eastern Finland, Niuvanniemi Hospital  Kuopio Finland"},{"name":"Department of Clinical Neuroscience, Karolinska Institutet and Centre for Psychiatry Research Stockholm Health Care Services, Region Stockholm  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,1,14]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"World Health Organization (WHO).Global Status Report on Alcohol and Health 2018. 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