Could a Common Asthma Drug Curb Drinking?

A medication designed to treat asthma showed no benefit over fake pills in helping most people reduce alcohol consumption. However, UCLA scientists found it helped women drink less during a recent clinical trial.

Researchers gave 102 adults with serious drinking problems either ibudilast or a placebo twice daily for three months. Results published in JAMA Network Open revealed the respiratory drug worked no better than dummy pills for the full group. Still, women taking the real medication saw greater decreases in daily alcohol intake.

Lara Ray, a UCLA psychology professor who led the study, said the findings point toward future research directions despite the overall disappointing results.

"While ibudilast was not superior to the placebo, we saw that some individuals did better and some did worse with the drug," Ray said. "Female study participants did better, but both men and women who came in with higher levels of depression did worse, which are results we can use to guide further research."

The trial caps off several years of work by Ray's UCLA Addictions Lab examining whether ibudilast could treat alcohol dependency. Japanese authorities approve the drug for respiratory conditions and dizziness following strokes. Prior research suggested it might help people cut back on drinking.

Scientists monitored drinking patterns, including heavy consumption days, average drinks consumed during drinking sessions, and alcohol-free periods over 12 weeks of treatment plus four weeks of follow-up observation.

Both treatment groups reduced their alcohol intake substantially during the study period. Participants initially consumed about seven alcoholic drinks per drinking day but lowered that amount to roughly three to four drinks by the trial's conclusion. However, since placebo recipients achieved similar improvements, researchers were unable to establish the medication's effectiveness.

Ray said alcohol treatment research faces inherent difficulties in proving drug benefits beyond what patients experience simply from receiving care.

"One of the challenges in alcohol use disorder trials is that all participants usually improve their drinking across the board," she explained. "Participants are responding to the whole treatment setting, and regardless of medication, we see a very pronounced beneficial effect on alcohol use disorder. So it can be hard to tease apart the placebo effect from the medication."

When researchers examined different patient subgroups, they discovered notable variations in treatment response. Women who received actual ibudilast consumed fewer drinks per drinking occasion compared to females given inactive pills. By contrast, participants who entered the study with more severe depression symptoms performed better when taking placebos, showing reduced drinking and more days without alcohol.

Blood analysis revealed no changes in inflammatory markers throughout treatment despite ibudilast's known effects on inflammatory pathways.

Ray's research team believes immune system problems and inflammatory responses play key roles in mental health disorders, especially depression and alcohol addiction. Since women generally have more active inflammatory systems than men, this biological difference might explain why the medication produced better outcomes in female participants.

"We think that there's a strong immune contribution to psychiatric disorders, especially depression and alcohol use disorder," Ray said. "Women generally have higher inflammation levels, and the fact that ibudilast works better for them and worse for people with more depressive symptoms suggests that we may be on the right track. Immune treatments have revolutionized cancer treatment, and we're using this novel approach to do that for alcohol use disorder."

Scientists plan to analyze their data further to determine which patient characteristics may predict successful treatment with ibudilast, particularly in individuals with chronic pain conditions or high inflammation levels, before initiating therapy.

Longer clinical trials may help researchers better distinguish genuine medication effects from improvements that result solely from participating in structured treatment programs. Ray suggested studies lasting six months could provide clearer evidence of drug-specific benefits versus general care effects.

Federal agencies focused on alcohol research provided funding for the investigation. Sustained government investment will be needed to develop new treatment options for drinking disorders that impact millions of Americans.

"Our lab is uncovering novel treatments for substance use disorders, and we're excited that all the people who came into our study improved," Ray said. "One of the challenges going forward is to follow people a little bit longer, say, in a six-month trial, so that we can get more of a separation between the treatment context and the active medication effect."

Ray emphasized that participants trust UCLA's research reputation, which encourages honest reporting about drinking behaviors and may contribute to positive changes.

"People are coming to our lab because they trust UCLA," she said. "They're reporting on their drinking regularly, and that, in and of itself, is causing pretty significant changes in their behavior."

The National Institute on Alcohol Abuse and Alcoholism provided funding for this trial, and the federal government will need to continue to support the UCLA Addiction Lab's ongoing trials in order to create new, effective treatments for a problem that affects almost 30 million adults in the US alone.

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