Historique
Périodique
A multi-center randomized trial of buprenorphinenaloxone versus clonidine for opioid, detoxification: findings from the National Institute on Drug Abuse Clinical Trials Network
(Un essai randomisé multi-site de comparaison de lefficacité dune association buprénorphine-naloxone et de la clonidine dans le sevrage des opioïdes : les résultats du réseau d'essais cliniques du NIDA - National Institute on Drug Abuse)
Auteur(s) :
LING, W. ;
AMASS, L. ;
SHOPTAW, S. ;
ANNON, J. J. ;
HILLHOUSE, M. ;
BABCOCK, D. ;
BRIGHMA G. ;
HARRER, J. ;
REID, M. ;
MUIR J. ;
BUCHAN B. ;
ORR D. ;
WOODY, G. ;
KREJCI, J. ;
ZIEDONIS, D. ;
Buprenorphine Study Protocol Group
Année
2005
Page(s) :
1090-1100
Langue(s) :
Anglais
Refs biblio. :
27
Domaine :
Drogues illicites / Illicit drugs
Thésaurus mots-clés
SEVRAGE
;
OPIOIDES
;
BUPRENORPHINE
;
NALOXONE
;
CLONIDINE
;
EFFICACITE
;
COMPARAISON
Note générale :
Addiction, 2005, 100, (8), 1090-1100
Résumé :
FRANÇAIS :
L'étude a porté sur 113 patients hospitalisés (77 sous buprénorphine-naloxone, 36 sous clonidine) et 231 patients en traitement ambulatoire (157 sous buprénorphine-naloxone, 74 sous clonidine). Les critères d'évaluation du traitement sont : la rétention en traitement sur toute la durée du programme et des tests urinaires négatifs. Les résultats montrent une meilleure efficacité de l'association buprénorphine-naloxone par rapport à la clonidine.
ENGLISH :
AIMS: The clinical effectiveness of buprenorphine-naloxone (bup-nx) and clonidine for opioid detoxification in in-patient and out-patient community treatment programs was investigated in the first studies of the National Institute of Drug Abuse Clinical Trials Network.
DESIGN: Diagnostic and Statistical Manual version IV (DSM IV)-diagnosed opioid-dependent individuals seeking short-term treatment were randomly assigned, in a 2 : 1 ratio favoring bup-nx, to a 13-day detoxification using bup-nx or clonidine.
METHODS: A total of 113 in-patients (77 bup-nx, 36 clonidine) and 231 out-patients (157 bup-nx, 74 clonidine) participated. Supportive interventions included appropriate ancillary medications and standard counseling procedures guided by a self-help handbook. The criterion for treatment success was defined as the proportion of participants in each condition who were both retained in the study for the entire duration and provided an opioid-free urine sample on the last day of clinic attendance. Secondary outcome measures included use of ancillary medications, number of side effects reported and withdrawal and craving ratings.
FINDINGS: A total of 59 of the 77 (77%) in-patients assigned to the bup-nx condition achieved the treatment success criterion compared to eight of the 36 (22%) assigned to clonidine, whereas 46 of the 157 (29%) out-patients assigned to the bup-nx condition achieved the treatment success criterion, compared to four of the 74 (5%) assigned to clonidine.
CONCLUSION: The benefits of bup-nx for opioid detoxification are supported and illustrate important ways in which clinical research can be conducted in community treatment programs.
L'étude a porté sur 113 patients hospitalisés (77 sous buprénorphine-naloxone, 36 sous clonidine) et 231 patients en traitement ambulatoire (157 sous buprénorphine-naloxone, 74 sous clonidine). Les critères d'évaluation du traitement sont : la rétention en traitement sur toute la durée du programme et des tests urinaires négatifs. Les résultats montrent une meilleure efficacité de l'association buprénorphine-naloxone par rapport à la clonidine.
ENGLISH :
AIMS: The clinical effectiveness of buprenorphine-naloxone (bup-nx) and clonidine for opioid detoxification in in-patient and out-patient community treatment programs was investigated in the first studies of the National Institute of Drug Abuse Clinical Trials Network.
DESIGN: Diagnostic and Statistical Manual version IV (DSM IV)-diagnosed opioid-dependent individuals seeking short-term treatment were randomly assigned, in a 2 : 1 ratio favoring bup-nx, to a 13-day detoxification using bup-nx or clonidine.
METHODS: A total of 113 in-patients (77 bup-nx, 36 clonidine) and 231 out-patients (157 bup-nx, 74 clonidine) participated. Supportive interventions included appropriate ancillary medications and standard counseling procedures guided by a self-help handbook. The criterion for treatment success was defined as the proportion of participants in each condition who were both retained in the study for the entire duration and provided an opioid-free urine sample on the last day of clinic attendance. Secondary outcome measures included use of ancillary medications, number of side effects reported and withdrawal and craving ratings.
FINDINGS: A total of 59 of the 77 (77%) in-patients assigned to the bup-nx condition achieved the treatment success criterion compared to eight of the 36 (22%) assigned to clonidine, whereas 46 of the 157 (29%) out-patients assigned to the bup-nx condition achieved the treatment success criterion, compared to four of the 74 (5%) assigned to clonidine.
CONCLUSION: The benefits of bup-nx for opioid detoxification are supported and illustrate important ways in which clinical research can be conducted in community treatment programs.
Affiliation :
David Geffen School of Medicine, NPI/Integrated Substance Abuse Programs, University of California, Los Angeles, CA 90025, USA