Retention rate and illicit opioid use during methadone maintenance interventions:: a meta-analysis
Retention rate and illicit opioid use during methadone maintenance interventions:: a meta-analysis
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DOI：
10.1016/s0376-8716(01)00171-5
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发表时间：
2002-02-01
影响因子：
4.2
通讯作者：
Camí, J
中科院分区：
文献类型：
--
作者：
Farré, M;Mas, A;Camí, J
通过随机、对照和双盲临床试验的荟萃分析，从方案保留率和减少非法阿片类药物使用的角度评估了美沙酮维持对阿片类药物成瘾的疗效。结果与丁丙诺啡和左旋乙酰美沙醇（LAAM）干预进行比较。从1966年至1999年12月的PubMed(R)数据库中，使用“美沙酮”和“随机对照试验”作为主要医学主题，确定了试验。对来自13项研究的1944名阿片类药物依赖患者的数据进行了分析。64%的患者接受了固定剂量或调整剂量的美沙酮治疗。因此，890例患者接受大于或等于50mg /天（高剂量组），392例患者接受< 50mg /天（低剂量组）。在662名对照组中，131名接受安慰剂治疗，350名接受丁丙诺啡治疗（265名剂量≥8mg /天，85名剂量< 8mg /天），181名接受LAAM治疗。高剂量美沙酮在减少非法阿片类药物使用方面比低剂量更有效（优势比[OR] 1.72, 95%可信区间[CI] 1.26-2.36）。在保留率和非法阿片类药物使用方面，高剂量美沙酮明显比低剂量丁丙诺啡（< 8mg /天）更有效，但在这两个参数方面与高剂量丁丙诺啡（≥8mg /天）相似。与接受高剂量美沙酮治疗的患者相比，接受LAAM治疗的患者保留失败的风险更高（OR 1.92, 95% CI 1.32-2.78）。在激动剂维持方案中，50mg /天或更高剂量的口服美沙酮是阿片类药物依赖的首选药物。(C) 2002爱思唯尔科学爱尔兰有限公司版权所有。
The efficacy of methadone maintenance in opioid addiction was assessed in terms of programme retention rate and reduction of illicit opioid use by means of a meta-analysis of randomised, controlled and double blind clinical trials. The results were compared with interventions using buprenorphine and levo-acetylmethadol (LAAM). Trials were identified from the PubMed(R) database froth 1966 to December 1999 using the major medical subject headings 'methadone' and 'randomised controlled trial'. Data for a total of 1944 opioid-dependent patients from 13 studies were analysed. Sixty-four percent of patients received methadone, administered either as fixed or adjusted doses. Thus, 890 patients received greater than or equal to 50 mg/day (high dose group) and 392 were given < 50 mg/day (low dose group). Of 662 controls, 131 received placebo, 350 buprenorphine (265 at doses ≥ 8 mg/day and 85 at doses < 8 mg/day) and 181 LAAM. High doses of methadone were more effective than low doses in the reduction of illicit opioid use (odds ratio [OR] 1.72, 95% confidence interval [CI] 1.26-2.36). High doses of methadone were significantly more effective than low doses of buprenorphine ( < 8 mg/day) for retention rates and illicit opioid use, but similar to high doses of buprenorphine ( ≥ 8 mg/day) for both parameters. Patients treated with LAAM had more risk of failure of retention than those receiving high doses of methadone (OR 1.92, 95% CI 1.32-2.78). It is proposed that in agonist-maintenance programmes, oral methadone at doses of 50 mg/day or higher is the drug of choice for opioid dependence. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.