Titre : | Buprenorphine implants for treatment of opioid dependence. A randomized controlled trial (2010) |
Auteurs : | W. LING ; P. CASADONTE ; G. BIGELOW ; K. M. KAMPMAN ; A. A. PATKAR ; G. L. BAILEY ; R. N. ROSENTHAL ; K. L. BEEBE |
Type de document : | Article : Périodique |
Dans : | Journal of the American Medical Association (Vol.304, n°14, October 13, 2010) |
Article en page(s) : | 1576-1583 |
Note générale : |
Editorial: "Advances in the treatment of opioid dependence: continued progress and ongoing challenges", O'Connor P.G., p.1612-1614.
Letters to the editor & author's reply: "Buprenorphine implants and opioid dependence", D.A. Rastegar, JAMA 2011;305(3):253-5. |
Langues: | Anglais |
Discipline : | TRA (Traitement et prise en charge / Treatment and care) |
Mots-clés : |
Thésaurus géographique ETATS-UNISThésaurus mots-clés ETUDE RANDOMISEE ; BUPRENORPHINE ; TRAITEMENT DE MAINTENANCE ; VOIE D'ADMINISTRATION ; EFFICACITE ; OPIOIDES |
Résumé : |
Context: Limitations of existing pharmacological treatments for opioid dependence include low adherence, medication diversion, and emergence of withdrawal symptoms.
Objective: To determine the efficacy of buprenorphine implants that provide a low, steady level of buprenorphine over 6 months for the treatment of opioid dependence. Design, Setting, and Participants: A randomized, placebo-controlled, 6-month trial conducted at 18 sites in the United States between April 2007 and June 2008. One hundred sixty-three adults, aged 18 to 65 years, diagnosed with opioid dependence. One hundred eight were randomized to receive buprenorphine implants and 55 to receive placebo implants. Intervention: After induction with sublingual buprenorphine-naloxone tablets, patients received either 4 buprenorphine implants (80 mg per implant) or 4 placebo implants. A fifth implant was available if a threshold for rescue use of sublingual buprenorphine-naloxone treatment was exceeded. Standardized individual drug counseling was provided to all patients. Main Outcome Measure: The percentage of urine samples negative for illicit opioids for weeks 1 through 16 and for weeks 17 through 24. Results: The buprenorphine implant group had significantly more urine samples negative for illicit opioids during weeks 1 through 16 (P = .04). Patients with buprenorphine implants had a mean percentage of urine samples that tested negative for illicit opioids across weeks 1 through 16 of 40.4% (95% confidence interval [CI], 34.2%-46.7%) and a median of 40.7%; whereas those in the placebo group had a mean of 28.3% (95% CI, 20.3%-36.3%) and a median of 20.8%. A total of 71 of 108 patients (65.7%) who received buprenorphine implants completed the study vs 17 of 55 (30.9%) who received placebo implants (P Conclusion: Among persons with opioid dependence, the use of buprenorphine implants compared with placebo resulted in less opioid use over 16 weeks as assessed by urine samples. [Author's abstract] |
Domaine : | Drogues illicites / Illicit drugs |
Affiliation : | Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, United States / Etats-Unis |
Lien : | https://doi.org/10.1001/jama.2010.1427 |
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