Browsing by Author "Collier, Summer"

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    Safety and Tolerability of Injectable Extended‐Release Naltrexone for the Management of Alcohol Use Disorder in Advanced Alcohol‐Associated Liver Disease
    (John Wiley & Sons Ltd., 2025) Díaz Piga, Luis Antonio; Collier, Summer; Yin, Jeffrey; Loomba, Rohit
    Background: Pharmacologic treatment of alcohol use disorder (AUD) in patients with advanced alcohol-associated liver dis-ease (ALD) remains underutilised due to concerns regarding hepatotoxicity. Injectable extended-release naltrexone (XR-NTX)may offer a safer alternative by avoiding first-pass hepatic metabolism, but data on its safety and effectiveness in patients withadvanced ALD are limited.Aim: To describe the clinical experience with XR-NTX in individuals with advanced ALD, evaluating its safety, tolerability andimpact on liver function and alcohol use.Methods: Retrospective case series of adults with ALD who received at least one dose of XR-NTX 380 mg IM at a tertiary carecentre between 2023 and March 2025. Clinical data and laboratory tests were extracted from electronic health records over aminimum follow-up of 12 weeks. Safety was assessed based on adverse events and liver biochemistry. Alcohol use was evaluatedusing phosphatidylethanol (PEth) levels.Results: Fourteen individuals with ALD were included (2 had F3 and 9 cirrhosis Child A–B). The median age was 51 [44–65]years, 64% were male, and median follow-up was 127 days. Four patients (29%) experienced mild adverse effects (injection sitepain, nausea and vomiting, fatigue and sexual side effects); none had hepatotoxicity or hepatic decompensation. No significantchanges in liver function tests or MELD/Child-Pugh scores were observed during the follow-up period. Eight participants (57%)had a decrease in alcohol consumption, with a non-significant decline in PEth levels.