{"id":2038,"date":"2015-10-01T01:00:00","date_gmt":"2015-10-01T00:00:00","guid":{"rendered":"https:\/\/angh.net\/abstracts\/maintien-a-1-an-de-lefficacite-du-baclofene-chez-100-patients-alcoolo-dependants\/"},"modified":"2018-10-20T18:40:19","modified_gmt":"2018-10-20T16:40:19","slug":"maintien-a-1-an-de-lefficacite-du-baclofene-chez-100-patients-alcoolo-dependants","status":"publish","type":"post","link":"https:\/\/angh.net\/abstracts\/maintien-a-1-an-de-lefficacite-du-baclofene-chez-100-patients-alcoolo-dependants\/","title":{"rendered":"Maintien \u00e0 1 an de l\u2019efficacit\u00e9 du baclof\u00e8ne chez 100 patients alcoolo-d\u00e9pendants"},"content":{"rendered":"

2015<\/strong><\/p>\n

Barrault Camille. Lison Hortensia, Garioud Armand, Roudot-Thoraval Fran\u00e7oise, B\u00e9har V\u00e9ronique, Belloula Djamel, Medmoun Mourad, Pulwermacher Georges, Christelle Fourny, C\u00e9line Beauliet, Hag\u00e8ge Herv\u00e9, Cadranel Jean-Fran\u00e7ois<\/em><\/p>\n

H\u00e9patologie <\/strong>– \u00a02015-05-10 –\u00a0CO –<\/p>\n

________________________________<\/p>\n

Introduction
\nPlusieurs \u00e9tudes sugg\u00e8rent une efficacit\u00e9 du baclof\u00e8ne (BAC) chez les patients alcoolo-d\u00e9pendants. Cette mol\u00e9cule fait l\u2019objet d\u2019une recommandation temporaire d\u2019utilisation dans cette indication depuis mars 2014 (ANSM – point d\u2019information du 14-03-2014). Le but de notre observatoire est d’\u00e9valuer son efficacit\u00e9 et sa tol\u00e9rance chez des patients avec ou sans cirrhose. Nous pr\u00e9sentons les r\u00e9sultats \u00e0 M12.
\nPatients et M\u00e9thodes
\nTous les patients cons\u00e9cutifs ayant commenc\u00e9 un traitement par BAC entre juin 2010 et septembre 2013 (en hospitalisation ou en ambulatoire) dans deux services d’h\u00e9pato-gastroent\u00e9rologie de CHG ont \u00e9t\u00e9 inclus dans cette \u00e9tude prospective ouverte. Une fiche d’information \u00e9tait remise aux patients avant le d\u00e9but du traitement. La posologie \u00e9tait augment\u00e9e progressivement jusqu’\u00e0 obtenir une indiff\u00e9rence vis \u00e0 vis de l’alcool. Le suivi \u00e9tait assur\u00e9 par un h\u00e9patologue et\/ou un addictologue.
\nR\u00e9sultats
\nCent patients (75% hommes) d\u2019\u00e2ge moyen 53 ans dont 65 % avaient une cirrhose et 16% une pancr\u00e9atite ont commenc\u00e9 le traitement. A 1 an, 86 patients \u00e9taient suivis dont 83 trait\u00e9s, 9 \u00e9taient perdus de vue, 4 \u00e9taient d\u00e9c\u00e9d\u00e9s et 1 avait \u00e9t\u00e9 transplant\u00e9. Avec une posologie m\u00e9diane de BAC de 40 mg\/j (30 \u00e0 210 mg\/j), on observait une diminution significative de la consommation d\u00e9clar\u00e9e d\u2019alcool (CDA) moyenne: 106 g\/j vs 18 g\/j (p<0,001). La r\u00e9ponse au traitement (diminution de la consommation de plus de 50%) a \u00e9t\u00e9 obtenue chez 77% des patients, mais aucun facteur pr\u00e9dictif de r\u00e9ponse n\u2019a \u00e9t\u00e9 mis en \u00e9vidence. Parmi ceux-ci, 44 patients \u00e9taient abstinents et 20 avaient une consommation r\u00e9siduelle ≤ 30g\/j. Chez ces 64 patients ayant une consommation \u00e0 faible risque, on observait une am\u00e9lioration des marqueurs biologiques : diminution du taux des GGT de 4,8N \u00e0 2N (p<0,001), des ASAT de 2,6N \u00e0 1,1N (p<0,001), du VGM de 100,6μ3 \u00e0 92,8μ3 (p<0,001) et une augmentation du taux de plaquettes de 171 000\/mm3 \u00e0 193 000\/mm3 (p=0,032). Enfin, chez les 39 cirrhotiques de ce groupe, la fonction h\u00e9patocellulaire (TP, bilirubin\u00e9mie, albumin\u00e9mie) s\u2019am\u00e9liorait significativement (TP : 77% vs 69% (p<0,001), bilirubin\u00e9mie : 19,5 \u00b5mol\/L vs 34,2 \u00b5mol\/L (p=0,026), albumin\u00e9mie : 37,2 vs 34,2 g\/L (p=0,007)). Vingt patients ont rapport\u00e9 des effets ind\u00e9sirables non s\u00e9v\u00e8res n\u00e9cessitant un arr\u00eat du BAC dans 2 cas.
\nConclusion
\nCes r\u00e9sultats sugg\u00e8rent que l\u2019efficacit\u00e9 du BAC dans le traitement de l\u2019alcoolo-d\u00e9pendance chez des patients s\u00e9lectionn\u00e9s se maintient \u00e0 1 an au prix de peu d\u2019effets secondaires. Dans notre cohorte, le BAC associ\u00e9 \u00e0 une prise en charge m\u00e9dico-psycho-sociale a permis une diminution drastique de la consommation d\u2019alcool confirm\u00e9e par les marqueurs biologiques ainsi qu\u2019une am\u00e9lioration de la fonction h\u00e9patique chez les cirrhotiques.<\/p>\n","protected":false},"excerpt":{"rendered":"

2015 Barrault Camille. Lison Hortensia, Garioud Armand, Roudot-Thoraval Fran\u00e7oise, B\u00e9har V\u00e9ronique, Belloula Djamel, Medmoun Mourad, Pulwermacher Georges, Christelle Fourny, C\u00e9line Beauliet, Hag\u00e8ge Herv\u00e9, Cadranel Jean-Fran\u00e7ois H\u00e9patologie – \u00a02015-05-10 –\u00a0CO – ________________________________ Introduction Plusieurs \u00e9tudes sugg\u00e8rent une efficacit\u00e9 du baclof\u00e8ne (BAC) chez les patients alcoolo-d\u00e9pendants. Cette mol\u00e9cule fait l\u2019objet d\u2019une recommandation temporaire d\u2019utilisation dans cette indication […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[3],"tags":[26],"class_list":["post-2038","post","type-post","status-publish","format-standard","hentry","category-hepatologie","tag-26"],"yoast_head":"\nMaintien \u00e0 1 an de l\u2019efficacit\u00e9 du baclof\u00e8ne chez 100 patients alcoolo-d\u00e9pendants - Abstracts des congr\u00e8s de l'ANGH<\/title>\n<meta name=\"description\" content=\"ANGH R\u00e9sum\u00e9s congr\u00e8s H\u00e9patologie Gastroent\u00e9romogie Hepatology Gastroenterology Etudes cliniques Clinical study\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/angh.net\/abstracts\/maintien-a-1-an-de-lefficacite-du-baclofene-chez-100-patients-alcoolo-dependants\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Maintien \u00e0 1 an de l\u2019efficacit\u00e9 du baclof\u00e8ne chez 100 patients alcoolo-d\u00e9pendants - 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