Buprenorphine implants for treatment of opioid dependence: randomized comparison to placebo and sublingual buprenorphine/naloxone.
Buprenorphine implants for treatment of opioid dependence: randomized comparison to placebo and sublingual buprenorphine/naloxone.
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用于治疗阿片类药物依赖的丁丙诺啡植入物:与安慰剂和舌下丁丙诺啡/纳洛酮的随机比较。
DOI:
10.1111/add.12315
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发表时间:
2013
期刊:
影响因子:
--
通讯作者:
Beebe,KatherineL
中科院分区:
文献类型:
--
作者:
Rosenthal,RichardN;Ling,Walter;Casadonte,Paul;Vocci,Frank;Bailey,GenieL;Kampman,Kyle;Patkar,Ashwin;Chavoustie,Steven;Blasey,Christine;Sigmon,Stacey;Beebe,KatherineL
AimsTo evaluate the safety and efficacy of buprenorphine implants (BI) versus placebo implants (PI) for the treatment of opioid dependence. A secondary aim compared BI to open‐label sublingual buprenorphine/naloxone tablets (BNX).DesignRandomized, double‐blind, placebo‐controlled trial. Subjects received either four buprenorphine implants (80 mg/implant) (n= 114), four placebo implants (n= 54) or open‐label BNX (12–16 mg/day) (n= 119).SettingTwenty addiction treatment centers.ParticipantsAdult out‐patients (ages 18–65) with DSM‐IV‐TR opioid dependence.MeasurementsThe primary efficacy end‐point was the percentage of urine samples negative for opioids collected from weeks 1 to 24, examined as a cumulative distribution function (CDF).FindingsThe BI CDF was significantly different from placebo (P< 0.0001). Mean [95% confidence interval (CI)] proportions of urines negative for opioids were: BI = 31.2% (25.3, 37.1) and PI = 13.4% (8.3, 18.6). BI subjects had a higher study completion rate relative to placebo (64 versus 26%,P< 0.0001), lower clinician‐rated (P< 0.0001) and patient‐rated (P< 0.0001) withdrawal, lower patient‐ratings of craving (P< 0.0001) and better subjects' (P= 0.031) and clinicians' (P= 0.022) global ratings of improvement. BI also resulted in significantly lower cocaine use (P= 0.0016). Minor implant‐site reactions were comparable in the buprenorphine [27.2% (31 of 114)] and placebo groups [25.9% (14 of 54)]. BI were non‐inferior to BNX on percentage of urines negative for opioids [mean (95% CI) = 33.5 (27.3, 39.6); 95% CI for the difference of proportions = (−10.7, 6.2)].ConclusionsCompared with placebo, buprenorphine implants result in significantly less frequent opioid use and are non‐inferior to sublingual buprenorphine/naloxone tablets.
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