Efficacy and safety of pharmacological interventions for the treatment of cocaine use disorder: A systematic review and network meta-analysis.
Craig Paterson, Thomas Parkhouse, Chloe Burke et al.
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In 30 seconds
This systematic review and network meta-analysis compared pharmacological treatments for cocaine use disorder in adults. It included 218 reports from 163 double-blind randomised trials, involving 14 871 participants and 89 medications, and assessed effectiveness, acceptability and safety. No treatment category showed consistent benefit across effectiveness outcomes, and the authors found no convincing evidence that any pharmacological treatment was effective. Most results had some concerns or high risk of bias, and the evidence from the syntheses was generally judged very low certainty.
Key findings
- The review included 163 studies with 14 871 participants and assessed 89 unique medications.
- No treatment category showed consistent beneficial effects across all effectiveness outcomes.
- Synthesised evidence was generally judged very low certainty, with most study results at some concerns or high risk of bias.
Why it matters
The breadth of this review indicates that, despite investigation of many medications, the available trial evidence does not establish a pharmacological treatment with convincing effectiveness for cocaine use disorder. The low certainty of the evidence also means that apparent differences between interventions should be interpreted cautiously.
What to keep in mind
Most included study results had some concerns or high risk of bias, and the evidence from syntheses was generally very low certainty.