Methadone versus buprenorphine in pregnant addicts: a double‐blind, double‐dummy comparison study

Fischer, Gabriele; Ortner, R.; Rohrmeister, Klaudia; Jagsch, Reinhold; Baewert, Andjela; Langer, Martin; Aschauer, Harald

doi:10.1111/j.1360-0443.2006.01321.x

Cited by 209 publications

(244 citation statements)

References 27 publications

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“…The difference in treatment effect between BUP and MET was not significant from two RCTs 19, 20 and three OBSs 38, 39, 41 (Table 2 and Fig. 2a), but the direction differed by study design.…”

Section: Resultsmentioning

confidence: 89%

“…The effect estimate from three RCTs 19, 20, 21 indicated lower risk of preterm birth for BUP compared with MET. Similarly, the treatment effect among seven medium ROB OBSs 18, 38, 39, 41, 42, 43, 48 showed that BUP was associated with a decreased risk of preterm birth compared with MET (Table 2 and Fig.…”

Section: Resultsmentioning

confidence: 94%

“…Of 1111 citations identified, 140 full‐text papers were assessed for eligibility, and 18 studies 18, 19, 20, 21, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49 (reported in 23 papers 18, 19, 20, 21, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52) satisfied our inclusion criteria (Fig. 1).…”

Section: Resultsmentioning

confidence: 99%

“…1). The only three RCTs 19, 20, 21 (six papers 19, 20, 21, 50, 51, 52) that have been conducted to date were included (223 participants; published 2005–10) (Supporting information, Table S2). Fifteen OBSs 18, 34, 35, 36, 37, 38, 39, 41, 42, 43, 44, 45, 46, 47, 48 (17 papers) 18, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49 enrolled a total of 1923 participants in prospective 18, 34, 35, 36, 37, 38, 39, 41, 42, 45, 46, 47 ( n = 12) or retrospective 43, 44, 48 ( n = 3) cohort studies published 2001–15.…”

Section: Resultsmentioning

confidence: 99%

“…Seventeen studies 18, 19, 20, 21, 34, 35, 36, 37, 38, 39, 41, 42, 43, 44, 45, 47, 48 reported preterm births. The effect estimate from three RCTs 19, 20, 21 indicated lower risk of preterm birth for BUP compared with MET.…”

Section: Resultsmentioning

confidence: 99%

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Buprenorphine compared with methadone to treat pregnant women with opioid use disorder: a systematic review and meta‐analysis of safety in the mother, fetus and child

et al. 2016

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AimsTo assess the safety of buprenorphine compared with methadone to treat pregnant women with opioid use disorder.MethodsWe searched PubMed, Embase and the Cochrane Library from inception to February 2015 for randomized controlled trials (RCT) and observational cohort studies (OBS) that compared buprenorphine with methadone for treating opioid‐dependent pregnant women. Two reviewers assessed independently the titles and abstracts of all search results and full texts of potentially eligible studies reporting original data for maternal/fetal/infant death, preterm birth, fetal growth outcomes, fetal/congenital anomalies, fetal/child neurodevelopment and/or maternal adverse events. We ascertained each study's risk of bias using validated instruments and assessed the strength of evidence for each outcome using established methods. We computed effect sizes using random‐effects models for each outcome with two or more studies.ResultsThree RCTs (n = 223) and 15 cohort OBSs (n = 1923) met inclusion criteria. In meta‐analyses using unadjusted data and methadone as comparator, buprenorphine was associated with lower risk of preterm birth [RCT risk ratio (RR) = 0.40, 95% confidence interval (CI) = 0.18, 0.91; OBS RR = 0.67, 95% CI = 0.50, 0.90], greater birth weight [RCT weighted mean difference (WMD) = 277 g, 95% CI = 104, 450; OBS WMD = 265 g, 95% CI = 196, 335] and larger head circumference [RCT WMD = 0.90 cm, 95% CI = 0.14, 1.66; OBS WMD = 0.68 cm, 95% CI = 0.41, 0.94]. No treatment differences were observed for spontaneous fetal death, fetal/congenital anomalies and other fetal growth measures, although the power to detect such differences may be inadequate due to small sample sizes.ConclusionsModerately strong evidence indicates lower risk of preterm birth, greater birth weight and larger head circumference with buprenorphine treatment of maternal opioid use disorder during pregnancy compared with methadone treatment, and no greater harms.

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Section: Resultsmentioning

confidence: 89%

Section: Resultsmentioning

confidence: 94%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Buprenorphine compared with methadone to treat pregnant women with opioid use disorder: a systematic review and meta‐analysis of safety in the mother, fetus and child

et al. 2016

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Buprenorphine maintenance versus placebo or methadone maintenance for opioid dependence

Mattick

Kimber

Breen

et al. 2008

Cochrane Database of Systematic Reviews

311

127

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Buprenorphine maintenance versus placebo or methadone maintenance for opioid dependence

Mattick

Breen

Kimber

et al. 2014

Cochrane Database of Systematic Reviews

1,332

698

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Background Buprenorphine has been reported as an alternative to methadone and LAAM for maintenance treatment of opioid dependence, differing results are reported concerning its relative effectiveness indicating the need for an integrative review. Objectives To evaluate the effects of buprenorphine maintenance against placebo and methadone maintenance in retaining patients in treatment and in suppressing illicit drug use. Search strategy We searched the following databases up to 2001, inclusive: Cochrane Drugs and Alcohol Review Group Register, the Cochrane Controlled Trials Register, MEDLINE, EMBASE, Current Contents, Psychlit, CORK [www. state.vt.su/adap/cork], Alcohol and Drug Council of Australia (ADCA) [www.adca.org.au], Australian Drug Foundation (ADF-VIC) [www.adf.org.au], Centre for Education and Information on Drugs and Alcohol (CEIDA) [www.ceida.net.au], Australian Bibliographic Network (ABN), Library of Congress databases, available NIDA monographs, the College on Problems of Drug Dependence Inc. proceedings, the reference lists of all identified studies and published reviews. Authors of identified RCT's were asked about any other published or unpublished relevant RCT. Selection criteria Randomised clinical trials of buprenorphine maintenance versus either placebo or methadone maintenance for opioid dependence. Data collection and analysis Reviewers evaluated the papers separately and independently, rating methodological quality of concealment of allocation; data were extracted independently for meta-analysis and double-entered. Main results Thirteen studies met the inclusion criteria, all were randomised clinical trials, all but one were double-blind. The method of concealment of allocation was not clearly described in 11 of the studies, otherwise methodological quality was good. Buprenorphine given in flexible doses appeared statistically significantly less effective than methadone in retaining patient in treatment (RR= 0.82; 95% CI: 0.69-0.96).

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Methadone versus buprenorphine in pregnant addicts: a double‐blind, double‐dummy comparison study

Abstract: This preliminary study had limited power to detect differences but the trends observed suggest this kind of research is practicable and that further studies are warranted.

Cited by 209 publications

References 27 publications

Buprenorphine compared with methadone to treat pregnant women with opioid use disorder: a systematic review and meta‐analysis of safety in the mother, fetus and child

Buprenorphine compared with methadone to treat pregnant women with opioid use disorder: a systematic review and meta‐analysis of safety in the mother, fetus and child

Buprenorphine maintenance versus placebo or methadone maintenance for opioid dependence

Buprenorphine maintenance versus placebo or methadone maintenance for opioid dependence

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