缓释注射丁丙诺啡用于治疗阿片类药物使用障碍高危人群：FASTER-BUP研究

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence Pub Date : 2025-07-19 DOI:10.1016/j.drugalcdep.2025.112798

M. Eugenia Socias , Piper Dickhout , Jenna Langlois , Cameron Grant , Seonaid Nolan

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引用次数: 0

摘要

缓释注射丁丙诺啡（XR-BUP）已成为解决口服阿片类药物使用障碍（OUD）药物的一些依从性挑战的有希望的替代方案。然而，在美国以外的环境和高风险人群中，XR-BUP的实际评估是有限的。我们的目的是评估XR-BUP在低障碍门诊成瘾治疗环境中有复发过量风险的OUD患者中的可行性和临床应用。方法：在2022年9月15日至2024年7月2日期间，在加拿大BC省温哥华的一家低障碍门诊成瘾诊所，对25名OUD和复发性过量高风险（即终生过量史，芬太尼尿检阳性）的成人进行为期24周的观察性前瞻性队列研究，开始XR-BUP。主要终点为XR-BUP治疗6个月的保留。次要结局包括非法阿片类药物的使用和安全性。结果参与者以男性（64%）和白人（80%）居多，中位年龄44岁。几乎所有的参与者都有过量用药史（92.0%），76%的人在基线时使用芬太尼。只有8名（32.0%）参与者接受了6次预定的XR-BUP注射（注射次数中位数为2）。在17名停止研究的参与者中，有7人改用替代药物。在积极治疗期间，无阿片类药物就诊的平均百分比为28.5%。在72例注射中，只有10例（13.9%）与轻度注射部位反应相关。没有其他不良事件，包括过量用药，报告。结论：虽然XR-BUP在过量用药风险高的OUD患者中耐受性良好，但6个月的保留率很低，大多数人在治疗期间继续使用非法阿片类药物。

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Extended-release injectable buprenorphine for the treatment of opioid use disorder among individuals at high risk of overdose: The FASTER-BUP udy

Background

Extended-release injectable buprenorphine (XR-BUP) has emerged as a promising alternative to address some of the adherence challenges of oral opioid use disorder (OUD) medications. However, real-world evaluations of XR-BUP in settings outside the United States and high-risk populations are limited. Our aim was to evaluate the feasibility and clinical utility of XR-BUP among people with OUD at risk of recurrent overdose in a low-barrier outpatient addiction treatment setting.

Methods

24-week observational prospective cohort study of 25 adults with OUD and high risk of recurrent overdose (i.e., lifetime history of overdose, urine drug test positive for fentanyl) starting XR-BUP in a low-barrier outpatient addiction clinic in Vancouver, BC, Canada, between September 15, 2022 and July 2, 2024. The primary outcome was 6-month retention in XR-BUP treatment. Secondary outcomes included use of illicit opioids and safety.

Results

Participants were mostly men (64 %) and White (80 %), with a median age of 44 years old. Almost all participants had a lifetime history of prior overdose (92.0 %) and 76 % were using fentanyl at baseline. Only 8 (32.0 %) participants received the six scheduled XR-BUP injections (median number of injections 2). Of the 17 participants who discontinued the study, 7 switched to an alternative medication. The average percentage of opioid-free visits during the active treatment period was 28.5 %. Of the 72 injections administered, only 10 (13.9 %) were associated with mild injection site reactions. No other adverse events, including overdoses, were reported.

Conclusions

While XR-BUP was well tolerated in this sample of people with OUD at high risk of overdose, six-month retention rates were low and most continued to use illicit opioids while on treatment.

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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.