Extended-release naltrexone versus oral naltrexone for substance use disorders: A systematic review and meta-analysis

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence Pub Date : 2025-07-07 DOI:10.1016/j.drugalcdep.2025.112789

Ahmed Elmosalamy , Akanksha Sirohi , Amr Moustafa , Omar Masoud , Leslie C. Hassett , Bhanu P. Kolla , Balwinder Singh

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引用次数: 0

Abstract

Purpose

This systematic review and meta-analysis aimed to compare extended-release naltrexone (XR-NTX) and oral naltrexone (NTX) for treating substance use disorders (SUDs).

Methods

A comprehensive search of multiple databases (MEDLINE, Embase, Cochrane, APA PsycInfo, and Scopus) was conducted on October 1, 2024, with no date or language restrictions. Inclusion criteria were adults with SUDs, interventions with XR-NTX, comparisons with oral NTX, and outcomes on treatment persistence, hospitalizations, and emergency department (ED) visits. Randomized controlled trials (RCTs) and observational studies were included. Odds ratios were calculated using the Mantel-Haenszel random-effects model.

Results

Of the 1116 studies screened, 27 were selected for full-text review, 15 met the inclusion criteria (3 open-label RCTs [n = 340] and 12 retrospective studies [n = 18,695]) focusing on alcohol use disorder (AUD) and opioid use disorder (OUD), and 7 were included in the meta-analysis. We found no other SUD where the two interventions were compared. Treatment persistence was significantly higher with XR-NTX compared to oral NTX at both 3 months (OR 1.43 [95 % CI: 1.04–1.96], p = 0.03) and 6 months (OR 1.96 [95 % CI: 1.37–2.81], p = 0.0002). No significant differences were observed in healthcare utilization, including inpatient admissions (OR 0.69 [95 % CI: 0.30–1.61], p = 0.39) or ED visits (OR 1.17 [95 % CI: 0.61–2.26], p = 0.63).

Conclusions

Patients with AUD and OUD receiving XR-NTX stay in treatment longer than those receiving oral NTX. However, hospitalization and ED visit rates did not differ. Findings are limited due to a small number of RCTs.

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缓释纳曲酮与口服纳曲酮治疗物质使用障碍：一项系统综述和荟萃分析

目的：本系统综述和荟萃分析旨在比较缓释纳曲酮（XR-NTX）和口服纳曲酮（NTX）治疗物质使用障碍（sud）的疗效。方法于2024年10月1日对MEDLINE、Embase、Cochrane、APA PsycInfo、Scopus等多个数据库进行综合检索，无日期和语言限制。纳入标准为患有sud的成人、XR-NTX干预、与口服NTX的比较、治疗持久性、住院和急诊就诊的结果。纳入随机对照试验（RCTs）和观察性研究。比值比采用Mantel-Haenszel随机效应模型计算。结果在筛选的1116项研究中，27项被纳入全文综述，15项符合纳入标准（3项开放标签随机对照试验[n = 340]和12项回顾性研究[n = 18,695]），重点关注酒精使用障碍（AUD）和阿片类药物使用障碍（OUD）， 7项被纳入meta分析。我们没有发现两种干预措施比较的其他SUD。与口服NTX相比，XR-NTX治疗的持续时间在3个月（OR 1.43 [95% CI: 1.04-1.96], p = 0.03）和6个月（OR 1.96 [95% CI: 1.37-2.81], p = 0.0002）均显著高于口服NTX。在医疗保健利用方面没有观察到显著差异，包括住院（OR 0.69 [95% CI: 0.30-1.61], p = 0.39）或急诊科（OR 1.17 [95% CI: 0.61-2.26], p = 0.63）。结论接受XR-NTX治疗的AUD和OUD患者的治疗持续时间长于口服NTX治疗的患者。然而，住院率和急诊科就诊率没有差异。由于随机对照试验数量较少，研究结果有限。

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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来源期刊

Drug and alcohol dependence 医学-精神病学

CiteScore

7.40

自引率

7.10%

发文量

409

审稿时长

41 days

期刊介绍： Drug and Alcohol Dependence is an international journal devoted to publishing original research, scholarly reviews, commentaries, and policy analyses in the area of drug, alcohol and tobacco use and dependence. Articles range from studies of the chemistry of substances of abuse, their actions at molecular and cellular sites, in vitro and in vivo investigations of their biochemical, pharmacological and behavioural actions, laboratory-based and clinical research in humans, substance abuse treatment and prevention research, and studies employing methods from epidemiology, sociology, and economics.