Pharmacotherapy to Prevent Alcohol Relapse in Alcohol-Associated Liver Disease.
Current gastroenterology reports November 19, 2025 Wei Zhang, Soo Young Hwang, Jay Luther 1 citation
Alcohol use disorder drives alcohol-associated liver disease, and preventing relapse after abstinence is a major challenge. Naltrexone and acamprosate reduce relapse in the general AUD population, but data in ALD are limited. Baclofen is the only drug tested in randomized trials in cirrhosis, with early benefit but mixed later results. Gabapentin and topiramate are off-label options; emerging agents like GLP-1 receptor agonists, psilocybin, and FGF21 analogs show early signals. Pharmacotherapy is underutilized due to lack of insight, stigma, provider inexperience, and fragmented care. Integrated programs across the disease spectrum may improve uptake. Pharmacotherapy is effective yet underused for relapse prevention in ALD.