Hoffman Kent, Peyton Marvin L, Sumner Michael
Lake Howell Health Center, Maitland, FL (KH); Oklahoma Clinical Research, Oklahoma City, OK (MLP); and Orexo US, Inc., Morristown, NJ (MS).
J Addict Med. 2017 May/Jun;11(3):217-223. doi: 10.1097/ADM.0000000000000301.
To assess the safety of rapidly dissolving buprenorphine/naloxone sublingual tablets (BNX-RDT) in opioid-dependent patients.
This open-label, 24-week extension study enrolled patients who completed primary trials of BNX-RDT. Daily tablet doses ranged from 5.7 to 17.1 mg. The primary endpoint was safety; secondary assessments included opioid cravings, addiction severity, health-related quality of life (QOL), and workplace productivity at screening (final day of the primary trials) through study end, with changes measured from baseline of the primary trials.
In all, 665 patients received treatment; 292 (43.9%) completed the study. A total of 258 patients (38.8%) reported 557 treatment-emergent adverse events, most commonly headache (3.2%) and constipation (3.0%). Craving scores showed continued improvement on 100-mm visual analog scale (mean change from primary trial baseline, -52.8 at screening; mean change from extension trial baseline, -60.5 at week 24). Reductions in addiction severity from baseline of both the primary and extension trial were maintained through week 24 on multiple assessments, as were improvements in QOL on Short Form 36. Employment increased by 15% and mean (SD) hours worked per week increased by 4.6 (20.1) from baseline to study end. Mean (SD) scores for impact of opioid dependence on work productivity improved from 4.7 (3.0) at baseline to 0.9 (1.8) at study end (11-point scale).
Extended treatment with BNX-RDT demonstrated a safety profile similar to other BNX formulations, reduced opioid cravings, and improved both QOL and work productivity. Continued treatment may enable patients to advance in recovery and return to normal functioning.
评估速溶丁丙诺啡/纳洛酮舌下片(BNX-RDT)在阿片类药物依赖患者中的安全性。
这项开放标签的24周扩展研究纳入了完成BNX-RDT初步试验的患者。每日片剂剂量范围为5.7至17.1毫克。主要终点是安全性;次要评估包括阿片类药物渴求、成瘾严重程度、健康相关生活质量(QOL)以及从筛查(初步试验的最后一天)到研究结束时的工作场所生产力,变化以初步试验基线为参照进行测量。
共有665名患者接受治疗;292名(43.9%)完成了研究。共有258名患者(38.8%)报告了557起治疗中出现的不良事件,最常见的是头痛(3.2%)和便秘(3.0%)。渴求评分在100毫米视觉模拟量表上持续改善(初步试验基线时的平均变化,筛查时为-52.8;扩展试验基线时的平均变化,第24周时为-60.5)。在多次评估中,从初步试验和扩展试验基线开始的成瘾严重程度降低在第24周时仍得以维持,36项简明健康状况调查的生活质量改善情况也是如此。从基线到研究结束,就业率提高了15%,每周平均工作小时数增加了4.6(20.1)。阿片类药物依赖对工作生产力影响的平均(标准差)评分从基线时的4.7(3.0)改善到研究结束时的0.9(1.8)(11分制)。
BNX-RDT的延长治疗显示出与其他BNX制剂相似的安全性,减少了阿片类药物渴求,并改善了生活质量和工作生产力。持续治疗可能使患者在康复过程中取得进展并恢复正常功能。