Lofexidine May Effectively Alleviate Withdrawal Symptoms After Discontinuation From Short-Acting Opioids

Stomach pain
Stomach pain
Lofexidine may effectively alleviate opioid withdrawal symptoms.

The following article is part of conference coverage from the PAINWeek 2018 conference in Las Vegas, Nevada. Clinical Pain Advisor’s staff will be reporting breaking news associated with research conducted by leading experts in pain medicine. Check back for the latest news from PAINWeek 2018.

LAS VEGAS — Lofexidine may effectively alleviate opioid withdrawal symptoms, according to a study presented during the 2018 PAINWeek conference, held September 4-8.

The analysis was based on pooled data collected from 865 individuals from 2 placebo-controlled double-blind phase 3 clinical trials examining the efficacy of lofexidine in the 7 days following abrupt withdrawal from short-acting opioid treatments. The participants had opioid dependence and were ≥18 years. In one study, participants were randomly assigned 1:1 to receive lofexidine 2.88 mg or placebo for 5 days. In the other study, participants were randomly assigned 3:3:2 to receive lofexidine 2.16 mg, lofexidine 2.88 mg, or placebo for 7 days. 

The study’s primary outcome was scores on the Short Opiate Withdrawal Scale of Gossop (SOW-G), which assesses “feeling sick,” stomach cramps, muscle spasms, twitching, coldness, heart pounding, muscle tension, aches and pains, yawning, runny eyes, and sleeping issues.

The percentage of patients who completed the 7-day treatment period was 41.9% in the lofexidine 2.16 mg group and 40.7% in the lofexidine 2.88 mg group vs 28.2% of participants in the placebo group (P <.002 and P =.001, respectively). Mean SOW-G scores over the 7-day period were reduced in participants who had received lofexidine vs placebo (P <.05 for lofexidine 2.16 mg; P <.0001 for lofexidine 2.88 mg). For each of the symptoms scored, the mean score was higher in the placebo group than in either of the lofexidine groups.

“Pain and hyperalgesia can be a key symptom during opioid withdrawal whether or not opioids were originally used for pain relief and may interfere with opioid discontinuation,” noted the investigators. “Lofexidine provides a nonopioid treatment option for opioid withdrawal symptoms,” they concluded.  

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Pergolizzi JV, Pirner M, Clinch Thomas. Efficacy of lofexidine for opioid withdrawal syndrome: focus on pain symptoms. Poster 56. Presented at: Pain Week; September 4-8, 2018; Las Vegas NV. doi:10.1080/00325481.2018.1512253

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