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Despite growing interest in sex differences, evidence synthesis evaluating pharmacotherapy effectiveness by sex remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Approach<\/jats:title>\n                    <jats:p>Web of Science, PubMed, Scopus, PsycINFO and Cochrane were searched twice. Eligible records included RCTs or non\u2010randomised studies of adults with AUD receiving pharmacological interventions (licensed or off\u2010label), and reporting or providing outcomes (binary relapse or continuous alcohol consumption change) by sex. Multi\u2010level random\u2010effects models calculated risk ratios (RR) and standardised mean differences (SMD), with sex as a moderator.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Findings<\/jats:title>\n                    <jats:p>\n                      Twenty\u2010eight studies (25,041 participants, 25% female) were included. No outcomes were rated low risk of bias; non\u2010RCTs were moderate\u2010to\u2010high quality. Overall treatment effects vs. control were small for abstinence (RR\u2009=\u20090.96, 95% CI [0.52, 1.74]; 4 studies;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200995%) and modest for consumption reduction (SMD\u2009=\u20090.23, 95% CI [0.01, 0.45]; 13 studies;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200989%); sex did not meaningfully moderate these outcomes (ratio of RR\u2009=\u20091.04, 95% CI [0.87, 1.25]; \u0394SMD\u2009=\u20090.05, 95% CI [\u22120.09, 0.18]). Power was low (median 13.7%), requiring ~6358 participants per group to detect the observed sex difference. Narrative synthesis suggested possible sex differences for naltrexone and baclofen, while highlighting the influence of drug (e.g., tolerability), participant (e.g., drinking motives) and design factors (e.g., recruitment setting) on treatment response.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications<\/jats:title>\n                    <jats:p>AUD pharmacotherapies provide modest benefits, with sex differences remaining unclear. Future trials should be adequately powered, report sex\u2010specific outcomes and consider adherence, tolerability and psychosocial moderators.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Evidence for sex\u2010specific efficacy remains inconclusive. Patterns for naltrexone and baclofen warrant exploration in large, rigorously designed, sex\u2010stratified trials.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dar.70196","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T02:14:11Z","timestamp":1782267251000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effectiveness of Alcohol Use Disorder Pharmacotherapies by Sex: Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-1041-9083","authenticated-orcid":false,"given":"Juliette","family":"Allen","sequence":"first","affiliation":[{"name":"School of Psychology Liverpool John Moores University  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Jones","sequence":"additional","affiliation":[{"name":"School of Psychology Liverpool John Moores University  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