HealthDay News — Extended-release naltrexone is noninferior to buprenorphine-naloxone for maintaining short-term abstinence from heroin and other illicit substances, according to a study published online in JAMA Psychiatry.
Lars Tanum, MD, from The University of Oslo in Norway, and colleagues conducted a 12-week, multicenter trial at five urban addiction clinics in Norway. Opioid-dependent adults were recruited and randomized to daily oral flexible-dose buprenorphine-naloxone (79 individuals) or extended-release naltrexone hydrochloride (80 individuals).
The researchers found that retention was noninferior in the extended-release naltrexone group versus the buprenorphine-naloxone group (difference, -0.1; 95% CI, -0.2 to 0.1; P = .04), with mean time of 69.3 and 63.7 days, respectively (P = .33, log-rank test).
Extended-release naltrexone was noninferior to buprenorphine-naloxone in terms of the group proportion of total number of opioid-negative urine drug tests (difference, 0.1; 95% CI, -0.04 to 0.2; P < .001) and use of heroin (mean difference, -3.2; 95% CI, -4.9 to -1.5; P < .001) and other illicit opioids (mean difference, -2.7; 95% CI, -4.6 to -0.9; P < .001).
Significantly lower use of heroin and other illicit opioids was seen in the extended-release naltrexone group in superiority analysis. Regarding most other illicit substances, there were no significant differences between the treatment groups.
“Extended-release naltrexone was as effective as buprenorphine-naloxone in maintaining short-term abstinence from heroin and other illicit substances and should be considered as a treatment option for opioid-dependent individuals,” the authors write.
Tanum L, Klemmetsby S, Latif Z, et al. The effectiveness of injectable extended-release naltrexone vs daily buprenorphine-naloxone for opioid dependence [published online October 18, 2017]. JAMA Psychiatry. doi: 10.1001/jamapsychiatry.2017.3206