Neonatal Abstinence Syndrome Effectively Treated With Buprenorphine

What You Need to Know

In infants with neonatal abstinence syndrome, sublingual buprenorphine reduced the duration of treatment, decreased the length of hospital stay, and had a similar rate of adverse events when compared with oral morphine.

Trial Design

Double-blind, double-dummy study compared sublingual buprenorphine with oral morphine in the treatment of neonatal abstinence syndrome
63 infants (37 weeks gestation) who were exposed to opioids during pregnancy and displayed signs of the neonatal syndrome were randomized to receive buprenorphine or morphine
Adjunctive phenobarbital was utilized in infants with uncontrolled symptoms despite receiving the maximum dose of opioid
Primary endpoint: “duration of treatment for symptoms of neonatal opioid withdrawal”
Secondary endpoints: hospital stay length, percent of infants requiring adjunctive phenobarbital treatment, safety

Key Outcomes:

Shorter median duration of treatment observed in buprenorphine patients vs morphine patients (15 days vs 28 days, respectively; P <.001)
Median length of hospital stay was 21 days for buprenorphine patients vs 33 days for morphine patients (P <.001)
15% of buprenorphine patients (5 out of 33) received adjunctive phenobarbital vs 23% of morphine patients (7 out of 30) (P =.36)
Similar rates of adverse events observed between the 2 groups

Reference

Kraft WK, Adeniyi-jones SC, Chervoneva I, et al. Buprenorphine for the Treatment of the Neonatal Abstinence Syndrome. N Engl J Med. 2017. doi: 10.1056/NEJMoa1614835

This article originally appeared on MPR