Feasibility of direct induction onto long-acting injectable buprenorphine

IF 1.9 0 PSYCHOLOGY, CLINICAL
Thileepan Naren , Dean Membrey , Paul MacCartney , Ryan D'Cunha , Suzanne Nielsen , Sarah Garry
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Abstract

Introduction

When first introduced, induction onto long-acting injectable buprenorphine (LAIB) required a period of stabilization on sublingual buprenorphine, presenting a key treatment barrier for some patients. Recent regulatory changes allow for direct induction on a low-dose weekly LAIB preparation, yet few studies have examined direct induction onto higher dose weekly and monthly LAIB formulations. To address this gap, this case series reports on 129 patients who were commenced directly onto any LAIB preparation.

Methods

A retrospective audit and analysis of the electronic medical record at an urban low-threshold primary healthcare service providing care to a marginalized population of people who inject drugs in Melbourne, Victoria. The study extracted data for all patients who were commenced directly onto LAIB between 1st January 2024 to 31st December 2024.

Results

The study identified patients (n = 129) commenced directly onto any formulation of LAIB. Four patients (3 %) experienced precipitated withdrawal post direct induction onto LAIB, requiring unplanned medical review and symptomatic management but not hospitalization. No other adverse reactions were identified. Most (n = 85, 65.9 %) returned for their next LAIB dose with 57.4 % (n = 74) retained in LAIB treatment at three months.

Conclusion

This case series provides evidence that direct induction onto LAIB is feasible with rates of precipitated withdrawal similar to those previously reported for sublingual buprenorphine induction. Given the benefits of direct induction, in suitably screened patients this could be considered to be a preferred method of LAIB induction.
直接诱导制备长效注射丁丙诺啡的可行性。
简介:首次引入时,诱导使用长效注射丁丙诺啡(LAIB)需要一段时间的舌下丁丙诺啡稳定,这对一些患者来说是一个关键的治疗障碍。最近的变化允许直接诱导低剂量每周LAIB制剂,但很少有研究检查直接诱导高剂量每周和每月LAIB制剂。为了解决这一差距,本病例系列报告了129例直接开始使用任何LAIB制剂的患者。方法:对维多利亚州墨尔本的一个城市低门槛初级卫生保健服务机构的电子病历进行回顾性审计和分析,该机构为边缘人群注射毒品提供服务。该研究提取了2024年1月1日至2024年12月31日期间直接开始接受LAIB治疗的所有患者的数据。结果:该研究确定了患者(n = 129)直接开始使用任何配方的LAIB。4例患者(3 %)在直接诱导LAIB后出现急性停药,需要计划外的医学检查和症状管理,但未住院。未发现其他不良反应。大多数(n = 85 %,65.9% %)返回进行下一次LAIB剂量治疗,其中57.4% % (n = 74)在三个月时保留LAIB治疗。结论:本病例系列提供的证据表明,直接诱导到LAIB是可行的,其沉淀戒断率低于先前报道的舌下丁丙诺啡诱导。考虑到直接诱导的好处,在适当筛选的患者中,这可以被认为是诱导LAIB的首选方法。
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
Journal of substance use and addiction treatment
Journal of substance use and addiction treatment Biological Psychiatry, Neuroscience (General), Psychiatry and Mental Health, Psychology (General)
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