Comparative effectiveness of extended‐release naltrexone and sublingual buprenorphine for treatment of opioid use disorder among Medicaid patients.
Background and aims: Extended‐release naltrexone (XR‐NTX) and sublingual buprenorphine (SL‐BUP) are both approved for opioid use disorder (OUD) treatment in any medical setting. We aimed to compare the real‐world effectiveness of XR‐NTX and SL‐BUP. Design and setting: This was an observational activ...
| Publicado en: | Addiction Vol. 119; no. 11; pp. 1975 - 1987 |
|---|---|
| Autores principales: | , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Nov2024
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=180294039&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 180294039 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09652140 AIO jtl: Addiction issn: 09652140 maglogo: Y pubinfo: dt: Nov2024 vid: 119 iid: 11 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 180294039 178803909 180294039 180294039 10.1111/add.16630 180294039 ppf: 1975 ppct: 12 formats: fmt: – @attributes: type: T – @attributes: type: C – @attributes: type: P tig: atl: Comparative effectiveness of extended‐release naltrexone and sublingual buprenorphine for treatment of opioid use disorder among Medicaid patients. aug: au: Ross, Rachael K. Nunes, Edward V. Olfson, Mark Shulman, Matisyahu Krawczyk, Noa Stuart, Elizabeth A. Rudolph, Kara E. affil: Department of Epidemiology, Mailman School of Public Health, Columbia University, New York NY,, USA sug: subj: Naltrexone Administration and Dosage Buprenorphine Administration and Dosage Administration, Sublingual Substance Use Disorders Drug Therapy Medicaid New Jersey Medicaid California Treatment Outcomes Medication Compliance Overdose Risk Factors Human Nonexperimental Studies Prospective Studies Billing and Claims New Jersey California Adult Adolescence Middle Age Death Risk Factors Risk Assessment Descriptive Statistics Confidence Intervals Comparative Studies Funding Source Adult: 19-44 years Adolescent: 13-18 years Middle Aged: 45-64 years ab: Background and aims: Extended‐release naltrexone (XR‐NTX) and sublingual buprenorphine (SL‐BUP) are both approved for opioid use disorder (OUD) treatment in any medical setting. We aimed to compare the real‐world effectiveness of XR‐NTX and SL‐BUP. Design and setting: This was an observational active comparator, new user cohort study of Medicaid claims records for patients in New Jersey and California, USA, 2016–19. Participants/cases: The participants were adult Medicaid patients aged 18–64 years who initiated XR‐NTX or SL‐BUP for maintenance treatment of OUD and did not use medications for OUD in the 90 days before initiation. Our cohort included 1755 XR‐NTX and 9886 SL‐BUP patients. Measurements: We examined two outcomes up to 180 days after medication initiation: (1) composite of medication discontinuation and death and (2) composite of overdose and death. Findings In adjusted analyses, treatment with XR‐NTX was more likely to result in discontinuation or death by the end of follow‐up than treatment with SL‐BUP: cumulative risk 75.9% [95% confidence interval (CI) = 73.9%, 77.9%] versus 62.2% (95% CI = 61.2%, 63.2%), respectively (risk difference = 13.7 percentage points, 95% CI = 11.4, 16.0). There was minimal difference in the cumulative risk of overdose or death by the end of follow‐up: XR‐NTX 3.9% (95% CI = 3.0%, 4.8%) versus SL‐BUP 3.3% (95% CI = 2.9%, 3.7%); risk difference = 0.5 percentage points, 95% CI = –0.4, 1.5. Results were consistent across sensitivity analyses. Conclusions: Medicaid patients in California and New Jersey, USA, receiving treatment for opioid use disorder stayed in treatment longer on sublingual buprenorphine than on extended‐release naltrexone, but the risk of overdose was similar. Most patients in this study discontinued medication within 6 months, regardless of which medication was initiated. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|