AUD & Pain: Anti-Inflammatory Drug Hopeful?
Apremilast, an anti-inflammatory drug, shows considerable promise in addressing teh complexities of alcohol use disorder (AUD) and associated pain. This groundbreaking research reveals that apremilast could be repurposed to simultaneously reduce alcohol intake and alleviate pain sensitivity, a critical factor often hindering recovery. The study, published in JCI Insight, suggests apremilast, already FDA-approved for other conditions, might offer dual benefits. Rats treated with apremilast demonstrated reduced alcohol consumption and decreased pain sensitivity, offering hope for new treatments for AUD and chronic pain. The research emphasizes the role of increased gabaergic transmission in the brain. News Directory 3 is following this story closely. Discover what’s next for this potential breakthrough.
Apremilast Shows Promise for Alcohol Use Disorder and Pain Relief
A drug already approved by the Food and Drug Administration (FDA) for inflammatory conditions may offer relief for both alcohol intake and pain sensitivity, conditions often linked to alcohol use disorder (AUD), according to a preclinical study by Scripps Research scientists.
The study, published April 22, 2025, in JCI Insight, suggests apremilast, a phosphodiesterase-4 (PDE4) inhibitor, could be repurposed. Apremilast, which blocks an enzyme involved in inflammation, may serve as a dual-acting therapy for AUD, especially for those experiencing pain during or after alcohol consumption. The research highlights the potential of apremilast to reduce co-occurring drinking and mechanical allodynia during long-term abstinence.
The World Health Organization estimates that AUD affects 400 million individuals aged 15 and older. Chronic pain is a strong predictor of relapse, often overlooked in treatment. People with AUD commonly experience mechanical allodynia, where light touch feels painful. This sensitivity can persist during abstinence, contributing to continued alcohol use and relapse.
Marisa Roberto, neuroscience professor at Scripps Research and senior author, said the findings highlight the therapeutic value of apremilast to reduce co-occurring drinking and mechanical allodynia in long-term abstinence.
Apremilast,currently used for psoriasis and psoriatic arthritis,has shown promise in reducing alcohol drinking in prior studies involving both mice and humans. The new research expands on this by investigating whether apremilast can also alleviate pain associated with alcohol exposure.
Researchers tested apremilast on rats genetically predisposed to higher alcohol consumption,as well as a standard genetic strain. Both groups had access to alcohol and were treated with either apremilast or a placebo.
The results showed that apremilast significantly reduced alcohol intake across both strains and sexes. It also decreased pain sensitivity in most groups, both promptly after drinking and during abstinence, with effects lasting from 24 hours to four weeks after alcohol was removed.
Bryan Cruz, postdoctoral fellow at Scripps Research and first author, noted that the patterns of reduction differed between males and females, as well as between strains at specific time points. As an example, some male rats did not experience pain relief from apremilast, emphasizing the importance of considering biological sex in future research.
Further experiments revealed that apremilast increased GABAergic transmission, an inhibitory signaling process that regulates pain and stress, in the central amygdala, a brain region involved in both addiction and pain. This effect was only observed in the standard rat strain, suggesting that apremilast’s impact on brain signaling may depend on genetic background or vulnerability to AUD.
In both strains of male rats, alcohol exposure increased the expression of PDE4 genes in the brain, further supporting a connection between inflammation, pain, and compulsive alcohol use. While other PDE4 inhibitors have been studied for pain unrelated to alcohol consumption, apremilast may offer a path toward more personalized therapies for individuals with both AUD and pain. Clinical research is still needed to determine the drug’s efficacy for such conditions in humans.
What’s next
The researchers plan to investigate whether apremilast can alleviate anxiety and other negative emotional states that often arise during alcohol withdrawal.