Patients with alcohol-related cirrhosis or hepatitis prescribed acamprosate experienced a significantly higher hospital readmission rate—85% compared with 57% in controls—despite similar abstinence and mortality outcomes, according to a recent study. 

In the retrospective case-control study, published in BMJ Open Gastroenterology, investigators examined the impact of acamprosate use on outcomes in patients with alcohol-related cirrhosis and/or alcohol-associated hepatitis. The investigators assessed 451 patients admitted to a tertiary care center in the United Kingdom between 2014 and 2023, focusing on hospital readmission, abstinence from alcohol, and mortality as primary and secondary outcomes.

Among the patients, 55 of them were prescribed acamprosate during their hospitalization. Propensity score matching was used to create two cohorts of 53 patients each—those prescribed acamprosate and matched controls—to adjust for baseline differences. Prior to matching, the acamprosate group had significantly higher alcohol consumption (median = 155 units/week vs 80 units/week, P < .001), a greater prevalence of psychiatric comorbidities (42% vs 20%, P < .001), and were less likely to be partnered (35% vs 54%, P = .006) or employed (67% vs 44%, P < .001).

After matching, the investigators found that at 1 year, the acamprosate group had significantly higher hospital readmission rates (85% vs 57%, P < .001) and a greater median number of readmissions (3 vs 1, P < .001). Abstinence (30% vs 30%, P = NS) and mortality rates (13% vs 13%, P = NS) were similar between the groups. The patients prescribed acamprosate showed higher engagement with community alcohol services (81% vs 35%, P < .001), but this did not translate to improved clinical outcomes.

The study suggested that the higher readmission rates may reflect greater severity of alcohol use disorder in this subgroup. The investigators emphasized the need for further randomized controlled trials to better clarify acamprosate's role in this population.

Full disclosures can be found in the published study.