Patients With Opioid Dependence Prefer Depot vs Sublingual Buprenorphine

Subcutaneously administered depot buprenorphine was associated with better treatment satisfaction compared with sublingual buprenorphine in patients treated for opioid dependence, according to a study published in JAMA Network Open.

In this open-label trial, a total of 119 adult outpatients (mean age, 44.4 years) with opioid dependence in Australia were randomly assigned to weekly or monthly depot buprenorphine (n=60) or daily sublingual buprenorphine (n=59). Treatment was administered over a 24-week period.

Study investigators compared the 2 groups in terms of the 24-week differences in patient-reported treatment satisfaction, as assessed using the Treatment Satisfaction Questionnaire for Medication (TSQM). Other endpoints included treatment burden and safety.

At the time of enrollment, all patients were receiving sublingual buprenorphine. At 24 weeks, a significantly higher mean TSQM global satisfaction score was observed in the depot group vs the sublingual arm (82.5 vs 74.3; difference, 8.2; 95% CI, 1.7-14.6; P =.01).

Treatment with depot buprenorphine was associated with improved treatment burden, as indicated by significantly lower global scores on the Treatment Burden Questionnaire (13.2 vs 28.6; difference, -15.4; 95% CI, -22.6 to -8.2; P <.001).

Approximately 65% of participants in the depot buprenorphine arm reported 117 adverse drug reactions. Most reactions were injection site reactions of mild intensity. Up to 20.3% of patients in the sublingual buprenorphine reported 21 adverse drug reactions. There were no study withdrawals due to adverse reactions or events.

A limitation of this study was the inclusion of only those patients who were receiving treatment with buprenorphine prior to entry. For that reason, the findings may not be generalizable across treatment-naive patients.

In addition to the potential clinical implications, this “study highlights the application of patient-reported outcomes as alternate end points to traditional markers of substance use in addiction treatment outcome studies.”

Disclosure: This research was supported by Camurus AB. Please see the original reference for a full list of authors’ disclosures.

Reference

Lintzeris N, Dunlop AJ, Haber PS, et al. Patient-reported outcomes of treatment of opioid dependence with weekly and monthly subcutaneous depot vs daily sublingual buprenorphine: a randomized clinical trial. JAMA Netw Open. 2021;4(5):e219041. doi:10.1001/jamanetworkopen.2021.9041