{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T23:15:40Z","timestamp":1780960540026,"version":"3.54.1"},"reference-count":35,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:00:00Z","timestamp":1773705600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:00:00Z","timestamp":1773705600000},"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":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Acamprosate is generally considered safe in patients with liver disease because it is renally cleared. Baclofen has been shown to be safe and effective in patients with alcohol use disorder and alcohol\u2010associated cirrhosis. Both medications are guideline\u2010endorsed pharmacotherapies for patients with alcohol\u2010associated cirrhosis. However, the safety of baclofen relative to acamprosate remains uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To compare the safety profiles of baclofen and acamprosate in patients with alcohol\u2010associated cirrhosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a nationwide, multicenter cohort study using a target trial emulation framework. Adults with compensated alcohol\u2010associated cirrhosis who received a first prescription of baclofen or acamprosate within 6\u2009months of diagnosis were included. Propensity score matching (1:1) was used to balance 60 covariates. The primary outcome was major adverse liver outcomes (MALO), defined as a composite of hepatic decompensation events within 12\u2009months. Secondary outcomes included individual decompensation events and mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>After matching, 571 baclofen and 571 acamprosate initiators were analysed. The 1\u2010year incidence of MALO was higher in the baclofen group (34.3%) than in the acamprosate group (27.4%), corresponding to a hazard ratio (HR) of 1.32 (95% CI, 1.02\u20131.70). Among individual events, baclofen was associated with a higher risk of hepatic encephalopathy (HR 1.80; 95% CI, 1.21\u20132.69). No significant differences in other individual events or mortality were observed. Subgroup analyses suggested greater risk among patients aged 56\u201370\u2009years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this large real\u2010world study, baclofen was associated with a higher risk of hepatic encephalopathy compared with acamprosate in patients with compensated alcohol\u2010associated cirrhosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/apt.70619","type":"journal-article","created":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T15:16:13Z","timestamp":1773760573000},"page":"1673-1684","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Assessing Major Adverse Liver Outcomes With Baclofen Compared to Acamprosate in Compensated Alcohol\u2010Associated Cirrhosis"],"prefix":"10.1111","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2703-5954","authenticated-orcid":false,"given":"Yee Hui","family":"Yeo","sequence":"first","affiliation":[{"name":"Karsh Division of Gastroenterology and Hepatology Cedars\u2010Sinai Medical Center  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sepideh","family":"Mehravar","sequence":"additional","affiliation":[{"name":"Karsh Division of Gastroenterology and Hepatology Cedars\u2010Sinai Medical Center  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Englewood Hospital and Medical Center  Englewood New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7834-9825","authenticated-orcid":false,"given":"Ju Dong","family":"Yang","sequence":"additional","affiliation":[{"name":"Karsh Division of Gastroenterology and Hepatology Cedars\u2010Sinai Medical Center  Los Angeles California USA"},{"name":"Comprehensive Transplant Center Cedars\u2010Sinai Medical Center  Los Angeles California USA"},{"name":"Samuel Oschin Comprehensive Cancer Institute Cedars\u2010Sinai Medical Center  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyun\u2010Seok","family":"Kim","sequence":"additional","affiliation":[{"name":"Karsh Division of Gastroenterology and Hepatology Cedars\u2010Sinai Medical Center  Los Angeles California USA"},{"name":"Comprehensive Transplant Center Cedars\u2010Sinai Medical Center  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun","family":"Wang","sequence":"additional","affiliation":[{"name":"Karsh Division of Gastroenterology and Hepatology Cedars\u2010Sinai Medical Center  Los Angeles 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