Awaji Bassam H, Abanmi Sobhia N, Alqahtani Manar S, Alhodathi Leen, Alrehaili Mohammed, Aldohan Turki F, Alkhenaizan Abdulaziz S, Alsughayer Zahrah M, Alyahya Abdullah A, Alanazi Rahaf Mutab S, Aljohani Hadeel, Hassan Awaji Hosam Hadi, Alsuliman Sara Y
Otolaryngology, King Faisal Specialist Hospital and Research Centre, Riyadh, SAU.
College of Medicine, Majmaah University, Riyadh, SAU.
Cureus. 2025 Aug 11;17(8):e89769. doi: 10.7759/cureus.89769. eCollection 2025 Aug.
Opioid use disorder (OUD) is a chronic, relapsing condition with significant health and social consequences. Buprenorphine-naloxone (BUP-NX) and extended-release naltrexone (XR-NTX) are two primary medications used for OUD treatment. A systematic review and meta-analysis were conducted. PubMed, Embase, and Cochrane databases were searched to identify randomized controlled trials (RCTs) comparing BUP-NX and XR-NTX for OUD treatment. Studies were included based on predefined inclusion and exclusion criteria, including patient population, intervention, comparator, outcome measures, and study design. Pooled analyses were performed to assess differences in abstinence time, days of opioid use, negative urine samples, quality of life, and adverse effects. No significant difference was found between BUP-NX and XR-NTX in terms of abstinence time. However, XR-NTX demonstrated a significant advantage in reducing the number of days of opioid use. No significant differences were observed in terms of the number of negative urine samples or quality of life. Adverse effects were comparable between the two treatments. While both medications appear effective for OUD treatment, the choice between BUP-NX and XR-NTX may depend on individual patient factors. Further research is needed to clarify the long-term effects of these medications and to identify optimal treatment strategies for different patient populations.
阿片类药物使用障碍（OUD）是一种慢性复发性疾病，会产生严重的健康和社会后果。丁丙诺啡-纳洛酮（BUP-NX）和长效纳曲酮（XR-NTX）是用于治疗OUD的两种主要药物。进行了一项系统评价和荟萃分析。检索了PubMed、Embase和Cochrane数据库，以识别比较BUP-NX和XR-NTX治疗OUD的随机对照试验（RCT）。根据预先定义的纳入和排除标准纳入研究，包括患者人群、干预措施、对照、结局指标和研究设计。进行汇总分析以评估戒断时间、阿片类药物使用天数、尿样阴性天数、生活质量和不良反应方面的差异。在戒断时间方面，BUP-NX和XR-NTX之间未发现显著差异。然而，XR-NTX在减少阿片类药物使用天数方面显示出显著优势。在尿样阴性次数或生活质量方面未观察到显著差异。两种治疗的不良反应相当。虽然两种药物对OUD治疗似乎都有效，但在BUP-NX和XR-NTX之间的选择可能取决于个体患者因素。需要进一步研究以阐明这些药物的长期效果，并确定针对不同患者人群的最佳治疗策略。
