| Titre : | Buprenorphine versus methadone maintenance therapy: a randomized double-blind trial with 405 opioid-dependent patients (2003) |
| Titre traduit : | (Traitement de maintenance à la buprénorphine vs. à la méthadone : un essai randomisé en double aveugle auprès de 405 patients dépendants des opioïdes.) |
| Auteurs : | R. P. MATTICK ; R. ALI ; J. M. WHITE ; S. O'BRIEN ; S. WOLK ; C. DANZ |
| Type de document : | Article : Périodique |
| Dans : | Addiction (Vol.98, n°4, April 2003) |
| Article en page(s) : | 441-452 |
| Langues: | Anglais |
| Discipline : | TRA (Traitement et prise en charge / Treatment and care) |
| Mots-clés : |
Thésaurus mots-clés TRAITEMENT DE MAINTENANCE ; METHADONE ; BUPRENORPHINE ; EFFICACITE ; COMPARAISON ; ETUDE TRANSVERSALEThésaurus géographique AUSTRALIE |
| Résumé : |
FRANÇAIS :
La seule différence significative observée entre la buprénorphine et la méthadone, est la capacité de la buprénorphine à induire une meilleure rétention en traitement (10% de patient en plus). ENGLISH : AIMS:To assess the efficacy of buprenorphine compared with methadone maintenance therapy for opioid dependence in a large sample using a flexible dosing regime and the marketed buprenorphine tablet. DESIGN: Patients were randomized to receive buprenorphine or methadone over a 13-week treatment period in a double-blind, double-dummy trial. SETTING Three methadone clinics in Australia. PARTICIPANTS: Four hundred and five opioid-dependent patients seeking treatment. INTERVENTION: Patients received buprenorphine or methadone as indicated clinically using a flexible dosage regime. During weeks 1-6, patients were dosed daily. From weeks 7-13, huprenorphine patients received double their week 6 dose on alternate days. MEASUREMENTS: Retention in treatment, and illicit opioid use as determined by urinalysis. Self reported drug use, psychological functioning, HIV risk behaviour, general health and subjective ratings were secondary outcomes. FINDINGS: Intention-to-treat analyses revealed no significant difference in completion rates at 13 weeks. Methadone was superior to buprenorphine in time to termination over the 13-week period (Wald x2 = 4.3 71, df = 1. P = 0.037), but not separately for the single-day or alternate-day dosing phases. There were no significant between-group differences in morphine-positive urines, or in self reported heroin or other Illicit drug use. The majority (85%) of the buprenorphine patients transferred to alternate-day dosing were maintained in alternate-day dosing. CONCLUSIONS: Buprenorphine did not differ from methadone in its ability to suppress heroin use, but retained approximately 70% fewer patients. This poorer retention was due possibly to too-slow induction onto buprenorphine. For the majority of patients, buprenorphine can be administered on alternate days. |
| Domaine : | Drogues illicites / Illicit drugs |
| Refs biblio. : | 32 |
| Affiliation : |
National Drug and Alcohol Research Centre (NDARC), Univ. New South Wales, Sydney, NSW 2052 Australie. Australia. |
| Numéro Toxibase : | 206770 |
| Centre Emetteur : | 02 Coordonnateur |
| Cote : | Abonnement |
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