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:
Addiction (Abingdon, England)
影响因子:
--
通讯作者:
Beebe,KatherineL
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

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目的评价丁丙诺啡植入物(BI)与安慰剂植入物(PI)治疗阿片类药物依赖的安全性和有效性。第二个目的是比较BI与开放标签丁丙诺啡/纳洛酮舌下片(BNX)。设计随机、双盲、安慰剂对照试验。受试者接受4次丁丙诺啡植入物(80 mg/次)(n= 114), 4次安慰剂植入物(n= 54)或开放标签BNX (12-16 mg/天)(n= 119)。20个戒毒中心。参与者:DSM - IV - TR阿片类药物依赖的成年门诊患者(年龄18-65岁)。主要疗效终点是第1周至第24周收集的阿片类药物阴性尿液样本的百分比,以累积分布函数(CDF)进行检测。BI CDF与安慰剂有显著差异(P< 0.0001)。平均[95%可信区间(CI)]阿片类药物尿阴性比例为:BI = 31.2% (25.3, 37.1), PI = 13.4%(8.3, 18.6)。与安慰剂相比,BI受试者具有更高的研究完成率(64% vs 26%,P< 0.0001),较低的临床医生评分(P< 0.0001)和患者评分(P< 0.0001)戒断,较低的患者渴望评分(P< 0.0001)和较好的受试者(P= 0.031)和临床医生(P= 0.022)整体改善评分。BI也显著降低了可卡因的使用(P= 0.0016)。丁丙诺啡组[27.2%(114人中的31人)]和安慰剂组[25.9%(54人中的14人)]轻微的植入部位反应具有可比性。在阿片类药物尿阴性百分比上,BI不低于BNX[平均(95% CI) = 33.5 (27.3, 39.6);比例差异的95% CI =(−10.7,6.2)。结论与安慰剂相比,丁丙诺啡植入导致阿片类药物使用频率显著降低,且不逊于舌下丁丙诺啡/纳洛酮片。
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.
DOI: 10.1016/s0016-5085(79)80075-x
发表时间: 1979
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影响因子: 29.4
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DOI: 10.4049/jimmunol.119.4.1340
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DOI: --
发表时间: 1977
期刊: Gastroenterology
影响因子: 29.4
作者:
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DOI: --
发表时间: 1981
期刊: Immunology
影响因子: 6.4
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