Alcohol Use Disorder Clinical Trial
Official title:
Phone-based Safety Monitoring of the First Year of Baclofen Treatment for Alcohol Use Disorder: the BACLOPHONE Cohort Study
BACLOPHONE is a prospective multicenter cohort study, conducted in two nearby French regions
(Hauts-de-France and Normandie). BACLOPHONE consists of the monthly phone-based monitoring of
792 patients during their first year of baclofen prescription for alcohol use disorder.
The main objective of the study is to determine the rate of patients who stop baclofen due to
an adverse event (AE) in the first year of treatment.The BACLOPHONE study also aims to
determine which types of AEs and serious AEs are actually liable to baclofen, and which other
types are more likely the consequence of confounding factors, e.g., concomitant alcohol,
psychotropic medications or substance uses, and comorbidities.
Inclusions are performed by any previously-labeled baclofen-prescribing physician in the
Hauts-de-France or Normandie French regions.
INITIAL ASSESSMENT PHONE CALLS
In the 15 days following the inclusion, participants will receive two successive phone calls.
The first call will be performed by a physician investigator of the study who will:
re-explain the principles of the study to patients, check the absence of non-inclusion
criteria, and note the medical history, date of baclofen initiation and current dose,
undergoing medications and current doses, occurrence of AEs since the initiation of baclofen,
birthdate, weight, and height. The physician will also check whether specific safety elements
important with regards to the baclofen treatment are noticeable in the patient: history of
seizures, suicide, and other concurrent substance use. The second phone call is performed by
a clinical research associate (CRA) who will check the absence of non-inclusion criteria, and
collects the 30 last-days reported alcohol use according to alcohol timeline follow-back
(A-TLFB) method, date of initiation and current dose of baclofen, severity alcohol dependence
questionnaire (SADQ), alcohol use disorder identification test (AUDIT), and A-B
neuropsychological assessment schedule (ABNAS) which scores the current level of sedation in
patients with psychotropic drugs.
FOLLOW-UP PHONE CALLS
During the subsequent one-year follow-up, two types of phone interviews are performed: 1)
Monthly Standardized Interviews (MSI). MSIs consist in collecting the previous-month daily
use of alcohol using the A-TLFB, the daily dose of baclofen across the previous month, the
current ABNAS sedation score, any change in any associated medication, any change in any
substance use, and any AE reported by the patient. No predefined list of AEs is used, as the
investigator only asks the patient if he/she has noticed or experienced any unexpected
symptoms of health issues since the last call. The daily dose distribution of baclofen, i.e.,
hours and doses of baclofen intakes, are also systematically investigated in the patient. The
average subjective level of craving for alcohol is self-scored by the patient using a 0-10
verbal rating scale (i.e., 0 for no craving at all, to 10 for the most severe possible
craving). The daily hours of maximum craving is also noted.
2) Semi-standardized Pharmacovigilance Interviews (SPI) which are unscheduled, and are
performed in the case of an AE reported by the patient to the CRA, or in the case of a direct
phone call to the pharmacovigilance center by the patient or their baclofen prescriber, with
the aim to report an AE. Data collected are: current baclofen dose and recent changes in
baclofen dosing, recent and current drinking patterns, associated medications, type of AE,
'serious' feature of the AE according to the definition of the Food and Drugs Administration,
onset date and occurrence conditions. Patients can be secondarily re-contacted to assess the
final outcome of the AE, and to determine the causality score of baclofen regarding the AE,
using both the French causality method and the Naranjo's algorithm if applicable.
DELAYED PHONE CALL IN THE CASE OF BACLOFEN CESSATION
If baclofen is stopped for any reason during the year following the initiation, a last phone
interview will be conducted by the CRA 3 months after baclofen cessation.
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