Overview

• The phase II randomized trial enrolled 102 adults with moderate to severe alcohol use disorder, assigning them to twice-daily ibudilast or placebo over a 12-week treatment and four-week follow-up.
• Ibudilast did not outperform placebo in reducing overall drinking levels, as both groups saw average drinks per drinking day drop from about seven to three or four.
• Female participants taking ibudilast achieved a statistically significant reduction in drinks per drinking day compared to those on placebo.
• Participants presenting elevated depressive symptoms at baseline fared worse on ibudilast than on placebo, indicating psychiatric comorbidities may modulate treatment response.
• Ibudilast failed to lower peripheral inflammation markers, prompting calls for extended, phenotype-driven studies to clarify its neuroimmune effects in alcohol use disorder.