Buprenorphine Superior to Methadone in Treating Neonatal Abstinence Syndrome, Study Shows

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Often prescribed to pregnant women undergoing therapy for addiction, buprenorphine has not been used in clinical practice in prior studies.
Often prescribed to pregnant women undergoing therapy for addiction, buprenorphine has not been used in clinical practice in prior studies.

In babies born in withdrawal from drugs their mothers have taken, buprenorphine may be more effective than methadone at reducing duration of treatment and length of hospital stay, according to research published in the Journal of Pediatrics.

Often prescribed to pregnant women undergoing therapy for addiction, buprenorphine has not been used in clinical practice in prior studies. The incidence of neonatal abstinence syndrome (NAS) has increased dramatically in the United States, reaching 5.8 per 1000 live births in 2012.

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"The burden of NAS on public healthcare and on the family may be mitigated partially through the judicious selection of a therapeutic agent," Eric Hall, PhD, a researcher in the Perinatal Institute at Cincinnati Children's Hospital Medical Center, said in a statement. "Buprenorphine therapy may be superior to methadone for the management of infants with NAS experiencing select opioid exposures, including those whose mothers are not receiving methadone therapy or using methadone illicitly while pregnant."

To compare the duration of opioid treatment and length of stay among infants with NAS treated with buprenorphine versus methadone, researchers treated 201 infants at 6 newborn nurseries in southwest Ohio with either a 5-step buprenorphine protocol (n = 38) or a standard 8-step methadone protocol (n = 163).

The researchers found that those receiving buprenorphine were treated for an average of 9.4 days (CI 7.1-11.7) compared with 14 days (12.6-15.4) for those receiving methadone. The length of stay in the hospital was also shorter for infants receiving buprenorphine at 16.3 days (13.7-18.9) compared with 20.7 days (19.1-22.2) for those receiving methadone.

"These findings suggest that outcomes for NAS may be further optimized by developing individualized treatments centered on the type of opioid pregnant women are exposed to," said Dr Hall in a statement.

Reference

Hall ES, Isemann BT, Wexelblatt SL, et al. A Cohort Comparison of Buprenorphine versus Methadone Treatment for Neonatal Abstinence Syndrome. J. Pediatr. 2015; doi:10.1016/j.jpeds.2015.11.039.

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