What question did this study set out to answer?

To determine whether extended-release naltrexone is as effective as daily buprenorphine-naloxone in maintaining abstinence from illicit opioids among newly detoxified individuals.

October 19, 2017JAMA PsychiatryOpen Access

Effectiveness of Injectable Extended-Release Naltrexone vs Daily Buprenorphine-Naloxone for Opioid Dependence

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Authors

LTLars TanumAkershus University Hospital KSKristin Klemmetsby SolliAkershus University Hospital ZLZill-E-Huma LatifAkershus University Hospital

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Implication

Randomized trial demonstrates noninferior abstinence with extended-release naltrexone versus daily buprenorphine-naloxone in opioid dependence, indicating its viability as a primary maintenance...

Key Points

To determine whether extended-release naltrexone is as effective as daily buprenorphine-naloxone in maintaining abstinence from illicit opioids among newly detoxified individuals.
A 12-week, multicenter, outpatient, open-label randomized clinical trial conducted across 5 urban addiction clinics in Norway (NCT01717963).
Randomized 159 opioid-dependent adults to either intramuscular extended-release naltrexone (380 mg every 4 weeks; n=80) or daily oral flexible-dose buprenorphine-naloxone (4 to 24 mg/d; n=79).
Treatment retention was noninferior in the extended-release naltrexone group compared to the buprenorphine-naloxone group (difference, -0.1; 95% CI, -0.2 to 0.1; P = .04), with mean retention of 69.3 vs 63.7 days (P = .33).
Extended-release naltrexone met noninferiority for the mean proportion of opioid-negative urine drug tests (0.9 vs 0.8; difference, 0.1; 95% CI, -0.04 to 0.2; P < .001).
Superiority analysis revealed significantly fewer days of heroin use (mean difference, -3.2; 95% CI, -4.9 to -1.5; P < .001) and other illicit opioid use (mean difference, -2.7; 95% CI, -4.6 to -0.9; P < .001) with naltrexone.

Cite This Study

Tanum et al. (2017) studied this question.

synapsesocial.com/papers/6a9750c3d08ffd74dfc608fd https://doi.org/10.1001/jamapsychiatry.2017.3206

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Implication

Randomized trial demonstrates noninferior abstinence with extended-release naltrexone versus daily buprenorphine-naloxone in opioid dependence, indicating its viability as a primary maintenance...