JAMA Pub Date : 2026-04-27 DOI: 10.1001/jama.2026.2854

Manali I Patel

引用次数: 0

Symptom-Based Dosing for Neonatal Opioid Withdrawal: Research Summary. 基于症状给药治疗新生儿阿片类药物戒断：研究综述

JAMA Pub Date : 2026-04-25 DOI: 10.1001/jama.2026.0759

引用次数: 0

As-Needed Medications in Newborn Opioid Withdrawal: A Better Standard. 新生儿阿片类药物戒断所需药物：更好的标准。

JAMA Pub Date : 2026-04-25 DOI: 10.1001/jama.2026.6412

Matthew Grossman,Adam Berkwitt,Rachel Osborn

引用次数: 0

Symptom-Based Dosing for Neonatal Opioid Withdrawal: The OPTimize NOW Randomized Clinical Trial. 新生儿阿片类药物戒断症状给药：优化NOW随机临床试验

JAMA Pub Date : 2026-04-25 DOI: 10.1001/jama.2026.5782

Lori A Devlin,Denise C Babineau,Stephanie L Merhar,Sara B DeMauro,Walter K Kraft,Scott A Lorch,Abhik Das,Scott A McDonald,Evan Rhodes,Augusto F Schmidt,Lillian Trochinski,Margaret Crawford,Thitinart Sithisarn,Lawrence Leeman,Kelley Zagol Kovatis,Namasivayam Ambalavanan,Ryan W Smith,Sucheta Telang,Jennifer A Tioseco,Jennifer M McAllister,Scott L Wexelblatt,Bhanu Muniyappa,Patricia K Williams,Susan C Adeniyi-Jones,Crystal D Hill,Tanner Wright,Gregory M Sokol,Lynette Johnson,Richard W Hall,Scott D Duncan,Karen Puopolo,Krishna Dummula,Ann Anderson-Berry,Jonathan M Davis,Brenda Poindexter,Leslie W Young,

{"title":"Symptom-Based Dosing for Neonatal Opioid Withdrawal: The OPTimize NOW Randomized Clinical Trial.","authors":"Lori A Devlin,Denise C Babineau,Stephanie L Merhar,Sara B DeMauro,Walter K Kraft,Scott A Lorch,Abhik Das,Scott A McDonald,Evan Rhodes,Augusto F Schmidt,Lillian Trochinski,Margaret Crawford,Thitinart Sithisarn,Lawrence Leeman,Kelley Zagol Kovatis,Namasivayam Ambalavanan,Ryan W Smith,Sucheta Telang,Jennifer A Tioseco,Jennifer M McAllister,Scott L Wexelblatt,Bhanu Muniyappa,Patricia K Williams,Susan C Adeniyi-Jones,Crystal D Hill,Tanner Wright,Gregory M Sokol,Lynette Johnson,Richard W Hall,Scott D Duncan,Karen Puopolo,Krishna Dummula,Ann Anderson-Berry,Jonathan M Davis,Brenda Poindexter,Leslie W Young, ","doi":"10.1001/jama.2026.5782","DOIUrl":"https://doi.org/10.1001/jama.2026.5782","url":null,"abstract":"ImportanceInfants with neonatal opioid withdrawal syndrome (NOWS) who receive pharmacologic treatment are traditionally treated with a scheduled opioid taper. An alternate approach, symptom-based dosing, may better align treatment with withdrawal severity.ObjectiveTo compare time from birth to medical readiness for discharge for infants with moderate to severe withdrawal treated with either a symptom-based dosing or scheduled opioid taper approach.Design, Setting, and ParticipantsIn this cluster, crossover randomized clinical trial with run-in period, 23 US hospitals cared for infants using the Eat, Sleep, Console approach (ESC) or Finnegan-based care (a comprehensive scoring system to quantify severity of symptoms; 15 ESC and 8 Finnegan hospitals) and their preferred primary opioid. Opioid dosing was guided by study-approved, site-specific algorithms. Infants with NOWS with a gestational age at birth of at least 36 weeks and at risk for pharmacologic treatment were enrolled between March 25, 2024, and April 9, 2025, with the last 3-month assessment on July 15, 2025. Sample size analyses were conducted between August 1, 2024, and September 23, 2024.InterventionSites were randomized to 1 of 2 sequences: (1) symptom-based dosing followed by scheduled opioid taper or (2) scheduled opioid taper followed by symptom-based dosing.Main Outcome and MeasureTime from birth to medical readiness for discharge.ResultsOf the 626 enrolled infants (mean [SD] gestational age, 38 [1] weeks; 49% male), 383 were cared for with ESC (primary outcome cohort). The mean time to medical readiness for discharge was significantly shorter in the symptom-based dosing group compared with the scheduled opioid taper group (9.18 vs 11.61 days; adjusted mean ratio [aMR], 0.79 [95% CI, 0.65-0.96]). There was no difference in the risk for initiation of pharmacologic treatment (0.4 vs 0.41; adjusted risk ratio, 0.99 [95% CI, 0.77-1.27]) or length of stay (10.91 vs 12.09 days; aMR, 0.9 [95% CI, 0.72-1.13]) between groups. For infants in the symptom-based group, 35% (95% CI, 25%-45%) required scheduled opioid dosing due to withdrawal severity that was not controlled with intermittent dosing. In the Finnegan cohort (n = 243; planned secondary outcome), there were no significant differences in time to medical readiness for discharge (15.99 vs 17.56 days; aMR, 0.91 [95% CI, 0.72-1.15]) or length of stay (17.38 vs 19.39 days; aMR, 0.9 [95% CI, 0.69-1.16]). The inpatient composite safety outcome occurred rarely (in the ESC cohort, 3 of 188 in the symptom-based dosing vs 2 of 195 in the scheduled opioid taper groups).Conclusions and RelevanceSymptom-based dosing decreased time to medical readiness for discharge compared with a scheduled opioid taper approach among infants cared for with ESC.Trial RegistrationClinicalTrials.gov Identifier: NCT05980260.","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147743870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

CDC Warns About Medetomidine in the US Illegal Fentanyl Supply. 疾病预防控制中心警告美托咪定在美国非法芬太尼供应。

JAMA Pub Date : 2026-04-24 DOI: 10.1001/jama.2026.2119

Samantha Anderer

引用次数: 0

Could a Common Antidepressant Help Treat Methamphetamine Use Disorder? 一种常见的抗抑郁药能帮助治疗甲基苯丙胺使用障碍吗？

JAMA Pub Date : 2026-04-24 DOI: 10.1001/jama.2026.5755

Samantha Anderer

引用次数: 0

Oral Semaglutide Sustains Long-Term CVD Risk Factor Reductions. 口服西马鲁肽可长期降低心血管疾病危险因素。

JAMA Pub Date : 2026-04-24 DOI: 10.1001/jama.2026.2123

Samantha Anderer