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Liver Toxicity Encountered in the Veterans Administration Trial of Disulfiram in Alcoholics
Author(s) -
Iber Frank L,
Lee Kelvin,
Lacoursiere Roy,
Fuller Richard
Publication year - 1987
Publication title -
alcoholism: clinical and experimental research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.267
H-Index - 153
eISSN - 1530-0277
pISSN - 0145-6008
DOI - 10.1111/j.1530-0277.1987.tb01312.x
Subject(s) - disulfiram , medicine , placebo , bilirubin , alkaline phosphatase , toxicity , liver function tests , gastroenterology , liver injury , pharmacology , pathology , chemistry , biochemistry , alternative medicine , enzyme
Alcoholic subjects (453) were randomly assigned to disulfiram or placebo therapy and followed for up to 12 months for drinking. Drinking status was determined from interviews of the subject and a household contact each 2 months and from the analysis of eight blood samples or 39 urines submitted at intervals during the year. Liver status was monitored each 2 months by obtaining serum alkaline phosphatase, bilirubin, and AST. Sensitive criteria were arbitrarily selected to identify about 1/5 of the patients with episodic elevations of liver tests. There was no relationship of liver test elevations to disulfiram treatment. However, the elevated AST related significantly to drinking status ( p = 0.004) as did elevated bilirubin ( p = 0.044), but not elevated alkaline phosphatase ( p = 0.146). Two hundred one patients had liver test elevations at least one time and were continued on drug, four were dropped. One hundred seventy‐nine of these patients were drinking, 22 were abstinent, and four were indeterminant. It is concluded that patients on disulfiram with minor liver test abnormalities are usually drinking.