ORIRGINAL RESEARCH
OPRM1 (rs1799971) Genetic Polymorphism and Clinical Characteristics in Prolonged Naltrexone Therapy in Patients with Alcohol Dependence: A Prospective Observational Study of associations
Author information
- S.S. Miroshkin
- Moscow Research and Practical Centre on Addictions
- V.Yu. Skryabin
- Moscow Research and Practical Centre on Addictions
- S.A. Pozdniakov
- Moscow Research and Practical Centre on Addictions
- V.A. Ivanchenko
- Moscow Research and Practical Centre on Addictions
- V.V. Shipitsyn
- Moscow Research and Practical Centre on Addictions
- A.V. Masyakin
- Moscow Research and Practical Centre on Addictions
- Published
- December 30, 2025
- Pages
- 20-27
Abstract
Background. Pharmacogenetic factors may significantly influence the individual effectiveness of naltrexone in the treatment of alcohol dependence. One of the most extensively studied markers is the single-nucleotide polymorphism 118A>G (rs1799971) of the OPRM1 gene, which encodes the μ-opioid receptor — the primary molecular target of naltrexone.
Aim — to evaluate associations of the OPRM1 (rs1799971) polymorphism with alcohol craving severity, relapse frequency, remission duration, and treatment completion during extended-release naltrexone (ER-naltrexone) therapy.
Material and methods. An open-label prospective uncontrolled study included 100 patients diagnosed with alcohol dependence syndrome (ICD-10 codes F10.20/F10.21) in clinical remission. All participants received intramuscular extended-release naltrexone. Over 180 days we assessed relapse-free survival (primary: time to binge relapse; sensitivity: time to first alcohol trial), Penn Alcohol Craving Scale (PACS) trajectories, and six-injection completion. Genotyping for the rs1799971 polymorphism of the OPRM1 gene was performed using real-time polymerase chain reaction.
Results. In a dominant model (A/G + G/G vs A/A) no significant differences were detected: time to relapse (log-rank p = 0.248), time to first alcohol trial (p = 0.960), course completion (Odds ratio (OR) = 1.84; 95% confidence interval (95% CI): 0.62–5.49; p = 0.273), and PACS change 0 → 150 days (p = 0.340). Higher rehabilitation potential independently predicted completion (OR per 1-point increase = 1.09; 95% CI: 1.05–1.13; p < 0.001).
Conclusion. In this cohort, OPRM1 (rs1799971) polymorphism showed no detectable associations with relapse timing, completion, or craving trajectories under extended-release naltrexone; rehabilitation potential was the key clinical predictor of completion.
Keywords
- alcohol dependence
- pharmacogenetics
- extended-release naltrexone
- OPRM1
- rs1799971
- relapse
- alcohol craving
- personalized therapy
How to Cite
References
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