Opioid addiction

Could Depot Buprenorphine Effectively Treat Opioid Use Disorder?

Long-acting depot buprenorphine may be an effective treatment option for opioid use disorder, according to new findings.

Researchers arrived at this conclusion following a study of 428 adult participants with moderate-to-severe opioid use disorder across 35 US sites. The study was performed from December 29, 2015, to October 19, 2016.
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Participants were randomly assigned to one of the following treatment groups:

  • SC-BPN group (n = 213): Daily sublingual (SL) placebo and weekly (first 12 weeks; phase 1) and monthly (last 12 weeks; phase 2) subcutaneous (SC) buprenorphine.
  • SL-BPN/NX group (n = 215): Daily SL buprenorphine with naloxone for 24 weeks with matched weekly and monthly SC placebo injections.

According to study findings, response rates were 31 of 215 (14.4%) and 37 of 213 (17.4%) for the SL-BPN/NX and SC-BPN groups, respectively.

A total of 1099 of 3870 (28.4%) urine samples from the SL-BPN/NX group were opioid-negative compared with 1347 of 3834 (35.1%) samples from the SC-BPN group.

Furthermore, the cumulative distribution function (CDF) for the SC-BPN group was found to be statistically superior to that of the SL-BPN/NX group

The researchers noted that 48 participants (22.3%) in the SL-BPN/NX group and 40 (18.8%) in the SC-BPN group experienced injection site adverse events, none of which were severe.

“Compared with SL buprenorphine, depot buprenorphine did not result in an inferior likelihood of being a responder or having urine test results negative for opioids and produced superior results on the CDF of no illicit opioid use,” the researchers concluded. “These data suggest that depot buprenorphine is efficacious and may have advantages.”

—Christina Vogt

Reference:

Lofwall MR, Walsh SL, Nunes EV, et al. Weekly and monthly subcutaneous buprenorphine depot formulations vs daily sublingual buprenorphine with naloxone for treatment opioid use disorder: a randomized clinical trial [Published online May 14, 2018]. JAMA Intern Med. doi:10.1001/jamainternmed.2018.1052