Researchers at the Icahn School of Medicine, Mt. Sinai have published findings from the first comparative study of buprenorphine implants and sublingual buprenorphine in the management of opioid use disorder. The conclusions indicate that the implants were as effective as the sublingual formulation in achieving the main outcome measure, defined as maintaining abstinence from illicit opioids for at least 4 of the 6 months of the study. The efficacy of commonly administered sublingual buprenorphine can be compromised by failure to adhere to daily dosing schedules. Study author Richard Rosenthal, MD, Medical Director of Addiction Psychiatry at Mt. Sinai, said, “There are some individual and public health risks with daily dosing of sublingual buprenorphine, such as missed doses and accidental pediatric exposure, as well as the risk of theft or intentional diversion…buprenorphine implants are an opportunity to reduce adherence issues and may improve efficacy in stable patients with opioid dependence.”
The study enrolled 177 opioid-dependent participants with stable abstinence. Participants were randomly assigned to sublingual buprenorphine with placebo implants or buprenorphine implants with sublingual placebo. Over 6 months, 86% of participants receiving implants and 72% receiving sublingual buprenorphine maintained abstinence from opioids. Dr. Rosenthal commented that follow-up studies are needed to establish the rate of relapse following implant discontinuation, as well as to confirm the findings of efficacy in a broader population. The findings were published online last week in Journal of the American Medical Association (JAMA).
A news story about the study conclusions may be read here.
The article abstract may be read here.
Posted on July 22, 2016