For ALD patients who are active drinkers, treatment with Alda-1 may reduce acetaldehyde levels and consequently ameliorate liver toxicity, but may also have a risk to promote alcohol drinking in these patients.

Because ALD patients, who are not active drinkers, most likely have low levels of acetaldehyde, treatment of these patients with Alda-1 may not generate significant beneficial effects. Disulfiram is not recommended for patients with advanced ALD due to its potential severe hepatotoxicity. Indeed, disulfiram (or Antabuse™), an irreversible inhibitor of ALDH, is commonly prescribed to treat alcoholism to prevent acetaldehyde metabolism, which results in elevation of acetaldehyde and subsequently causes unpleasant effects and aversion to alcohol. What is the therapeutic potential of ALDH activators such as Alda-1 for the treatment of ALD? Because abstinence is the cornerstone for treatment of ALD, most ALD patients during treatment periods are not active drinkers or are commonly treated with approaches to eliminate alcohol ingestion.

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