Healthcare (Commonwealth Union) – A medication previously believed to be a hopeful option for treating alcohol use disorder has failed to deliver the expected results, according to a new clinical trial from UCLA.
Ibudilast, which is already approved in Japan for managing asthma and post-stroke dizziness, had shown potential in earlier studies to help curb alcohol consumption. However, new findings published in JAMA Network Open reveal that for the majority of participants, ibudilast was no more effective than a placebo—though one subgroup did appear to benefit from the drug.
“While ibudilast was not superior to the placebo, we saw that some individuals did better and some did worse with the drug,” explained UCLA psychology professor and the first author of the study, Lara Ray. “Female study participants did better, but both men and women who came in with higher levels of depression did worse, which are results we can use to guide further research.”
The findings represent the result of many years of studies looking into ibudilast by Ray’s team at the UCLA Addictions Lab. While the drug did not prove as effective as initially hoped, the mixed results still highlight the potential role of inflammation and the immune system in alcoholism. Similar to apremilast—another drug being tested for alcohol use disorder—ibudilast acts on immune responses and related inflammation.
Ray stated that they believe the immune system has a significant role in psychiatric conditions, particularly depression and alcohol use issues. She further indicated that women tend to have higher levels of inflammation, and the fact that ibudilast appears to work better for them—and less effectively in individuals with more depressive symptoms—suggests they may be on the right path.
Ray stated that one of the issues in carrying out clinical trials for alcohol use disorder is that participants often show positive results in their drinking habits across the board. She indicated that this suggests they are responding to the overall therapeutic environment, not just the medication, and as a result, distinguishing the specific impact of the drug from the placebo response becomes quite challenging.
It was noted however in the study that, women who received ibudilast consumed fewer drinks on days they drank. This effect was significant enough for the researchers to determine that further investigation into ibudilast’s potential to reduce alcohol consumption in women is justified. In contrast, participants who entered the study with more pronounced depressive symptoms reduced their drinking and experienced more alcohol-free days while on the placebo. The study also found that ibudilast had no effect on inflammation markers that could be gaged.
Ray further stated that their research group is looking into innovative treatments for substance use disorders, and they are optimistic that everyone who participated in the study showed progress. She indicated that a key goal for future research is to extend the study period—perhaps over six months—so they can better distinguish the effects of the treatment setting from those of the medication itself.
“Ongoing analyses of this clinical trial will help us elucidate who responds to this medication for alcohol use disorder, such as individuals reporting co-occurring pain and those with higher levels of inflammation to begin with.”
This trial received funding from the National Institute on Alcohol Abuse and Alcoholism. Moving forward, continued federal support will be essential for the UCLA Addiction Lab to advance its research and develop effective new treatments for a condition that impacts nearly 30 million adults in the United States.
Ray indicated that people come to their lab because they trust UCLA. She further pointed out that they are consistently reporting their drinking habits, and that alone is leading to meaningful changes in their behavior.
