Adverse Events at 1 Month Following Medication Initiation for Opioid Use Disorder Among Adolescents and Young Adults.

Mishka Terplan, Kevin E O'Grady, Laura B Monico, Robert P Schwartz, Jan Gryczynski, Marc J Fishman, Shannon Gwin Mitchell
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Abstract

Background: We assess adverse events (AEs) following medication initiation for adolescents and young adults with opioid use disorder (OUD).

Methods: This is a secondary analysis of a clinical trial of long-acting injectable naltrexone (LAI-naltrexone) among youth with OUD aged 15 to 21 years. Participants were recruited from residential treatment and placed into 1 of 3 treatment groups based on medication receipt at time of discharge (no medication, sublingual buprenorphine-naloxone [buprenorphine], or LAI-naltrexone). Frequencies and percentages of AEs by body system were compared by medication group at the 1-month follow-up visit. Logistic regression was used to compare groups on their likelihood of reporting an AE, overall and excluding injection site reactions.

Results: Of 199 participants, 71 (36%) received no medication, 59 (30%) buprenorphine, and 69 (35%) LAI-naltrexone at discharge. Participants who received LAI-naltrexone experienced more AEs, primarily due to injection site reactions (62%, accounting for 43% of all AEs among participants who received LAI-naltrexone). There were 6 reports of nonlethal overdose, 5 in the no medication, 1 in the buprenorphine, and none in the LAI-naltrexone group. Participants receiving LAI-naltrexone were more likely to report an AE compared to the other groups (P = .04), but this difference was no longer significant when excluding injection site reactions (P = .82).

Conclusions: Excluding injection site reactions, there were no significant differences in the likelihood of reporting an AE 1 month after receiving LAI-NTX, buprenorphine, and no medications. LAI-naltrexone should be among the medications offered for the treatment of OUD in youth.

青少年和年轻成年人阿片类药物使用障碍用药 1 个月后的不良事件。
背景:我们对患有阿片类药物使用障碍(OUD)的青少年用药后的不良事件(AEs)进行了评估:这是对长效注射用纳曲酮(LAI-naltrexone)临床试验的二次分析,研究对象为 15 至 21 岁患有阿片类药物使用障碍的青少年。参与者从住院治疗机构招募,根据出院时接受药物治疗的情况分为3个治疗组(不接受药物治疗、丁丙诺啡-纳洛酮[丁丙诺啡]舌下含服或LAI-纳曲酮)。在 1 个月的随访中,按药物组比较了各身体系统的 AE 频率和百分比。使用 Logistic 回归法比较各组报告 AE 的可能性,包括总体 AE 和不包括注射部位反应:在 199 名参与者中,71 人(36%)出院时未接受药物治疗,59 人(30%)接受丁丙诺啡治疗,69 人(35%)接受 LAI-naltrexone 治疗。接受 LAI-naltrexone 治疗的参与者出现了更多的 AEs,主要是注射部位反应(62%,占接受 LAI-naltrexone 治疗参与者所有 AEs 的 43%)。有 6 例非致命性药物过量报告,其中 5 例发生在无药物治疗组,1 例发生在丁丙诺啡组,而 LAI-naltrexone 组则没有。与其他组相比,接受LAI-纳曲酮治疗的参与者更有可能报告AE(P = .04),但如果排除注射部位反应,这一差异不再显著(P = .82):结论:除去注射部位反应,接受 LAI-NTX、丁丙诺啡和无药物治疗 1 个月后报告 AE 的可能性没有显著差异。LAI-纳曲酮应作为治疗青少年 OUD 的药物之一。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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