PORTLAND, Ore. — The drug apremilast is usually a prescription medication for skin conditions such as psoriasis and psoriatic arthritis, but researchers from Oregon Health & Science University suggest that the drug may also be incredibly helpful for people struggling with alcohol use disorder. On average, individuals taking the medication reduced their alcohol consumption by more than half — from five drinks per day to just two. Overall, they call these findings “incredibly promising.”
“I’ve never seen anything like that before,” says co-senior author Angela Ozburn, Ph.D., associate professor of behavioral neuroscience in the OHSU School of Medicine and a research biologist with the Portland VA Health Care System, in a university release.
Starting in 2015, Prof. Ozburn and collaborators have been searching a genetic database looking for compounds likely to counteract the expression of genes linked to excessive alcohol use. Apremilast, meanwhile, is an FDA-approved anti-inflammatory medication that typically treats skin diseases. It is available under the brand name Otezla.
The drugs works in both mice and people
Researchers tested the drug in two unique animal models featuring a genetic of risk of heavy drinking, as well as among a variety of other strains of mice at laboratories across the country. In each of those cases, apremilast appeared to lower drinking among numerous models predisposed to mild-to-heavy alcohol use. Apremilast seems to trigger increased activity within the nucleus accumbens, the region of the brain thought to control alcohol intake.
Next, scientists from the Scripps Research Institute in La Jolla, California tested apremilast in human participants. The Scripps team went on to conduct a double-blind, placebo-controlled clinical proof-of-concept study involving 51 people assessed over an 11-day course of treatment.
“Apremilast’s large effect size on reducing drinking, combined with its good tolerability in our participants, suggests it is an excellent candidate for further evaluation as a novel treatment for people with alcohol use disorder,” explains co-senior author Barbara Mason, Ph.D., Pearson Family professor in the Department of Molecular Medicine at Scripps.
The clinical study included people diagnosed with alcohol use disorder who weren’t seeking any treatment for the condition. So, Prof. Mason predicts apremilast may be even more effective among people who are more motivated to lower their alcohol consumption.
“It’s imperative for more clinical trials to be done on people seeking treatment,” Prof. Ozburn notes. “In this study, we saw that apremilast worked in mice. It worked in different labs, and it worked in people. This is incredibly promising for treatment of addiction in general.”
There are few drugs which treat alcohol use disorder
Roughly 95,000 Americans die annually from alcohol-related deaths, according to the National Institute on Alcohol Abuse and Alcoholism. As far as current medication options, there are three approved meds for alcohol use disorder in the United States:
- Antabuse — which can actually cause an acute sensitivity very similar to a hangover whenever someone drinks alcohol
- Acamprosate — a medication believed to stabilize chemical signaling in the brain associated with alcohol relapse
- Naltrexone — a medication that blocks the euphoria brought about by both alcohol and opioids
The study is published in the Journal of Clinical Investigation.
