Prolonged-release buprenorphine formulations: Perspectives for clinical practice

Chappuy, Mathieu; Trojak, Benoît; Nubukpo, Philippe; Bachellier, Jérôme; Bendimerad, Patrick; Brousse, Georges; Rolland, Benjamin

doi:10.1016/j.therap.2020.05.007

Cited by 29 publications

(20 citation statements)

References 27 publications

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“…Further, the consumption of large amounts of potent street benzodiazepines, a particularly worrying issue among PWUD in Scotland, reduces the threshold of the ceiling effect of buprenorphine, removing the protection patients normally have against respiratory depression ( Independent Expert Working Group, 2017 ). Once administered, the depot injection dose cannot be removed and the long duration of action of buprenorphine magnified by its prolonged release formulation will limit the effectiveness of naloxone ( Chappuy et al, 2020 ). Unfortunately, the extent to which this scenario is likely to increase patient risk is as yet poorly understood.…”

Section: Discussionmentioning

confidence: 99%

“…The projected benefits of depot buprenorphine included increased protection of frontline workers and patients seeking MAT from droplet spread of COVID-19 by reducing daily or frequent attendances in pharmacies, enabling people who have been asked by the government to self-isolate or shield to be able to do so, reducing the impact upon patients of pharmacies being closed due to illness or quarantine ( Chappuy et al, 2020 ; Straub et al, 2020 ). Further, depot buprenorphine also negates the risks such as diversion or overdose implicit in allowing larger amounts of takeaway controlled drugs to minimize unnecessary travel, and the efficacy of treatment will no longer be dependent on the patients adherence to daily dosing, resulting in less risk of overdose and withdrawals ( Vorspan et al, 2019 ; Chappuy et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

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Using Microdosing to Induct Patients Into a Long-Acting Injectable Buprenorphine Depot Medication in Low Threshold Community Settings: A Case Study

et al. 2021

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Healthcare innovation has never been more important as it is now when the world is facing up to the unprecedented challenges brought by the COVID-19 pandemic. Within addictions services in Scotland, the priority has been to tackle our rising drug related death rate by maintaining and improving access to treatment while protecting frontline workers and managing operational challenges as a result of the pandemic. We present here a case study of five patients with opioid use disorder whose treatment represents a confluence of three important Medication Assisted Treatment (MAT) service innovations. The first was a low threshold drop in and outreach MAT service to rapidly and safely initiate opiate replacement therapy (ORT). The second was the provision of a microdosing regimen to enable same day induction to oral buprenorphine while minimizing the risk of precipitated opioid withdrawals and/or treatment disengagement. The third was rapid transitioning to an injectable long-acting buprenorphine depot which reduced unnecessary face to face patient contact and treatment non-adherence. This case study of five patients highlights the valuable role that buprenorphine microdosing can play in making induction to long-acting buprenorphine depot feasible to a broader range of patients, including those on a high dose methadone treatment regime.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Using Microdosing to Induct Patients Into a Long-Acting Injectable Buprenorphine Depot Medication in Low Threshold Community Settings: A Case Study

et al. 2021

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“…En ambos casos la duración de la liberación de buprenorfina a partir del sistema es de 1 mes (90). Su-blocade®, a diferencia de otros sistemas, debe conservarse en refrigeración (2-8 ºC) debido a que su estabilidad no supera los 7 días a temperatura ambiente (87). difusión de naltrexona a través del polímero, esta difusión proporciona una liberación sostenida de la naltrexona durante 30 días; esta rapidez en la instauración de la liberación permite que no haya que acudir a la suplementación oral de naltrexona en las etapas iniciales.…”

Section: Sublocade®unclassified

Extended-Release Delivery Systems of Opioids: Analgesia and Dependence

Pérez-López

Gómez-Lázaro

Aparicio-Blanco

2021

an.ranf

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The consumption of opioid analgesics has increased drastically in the last decades worldwide. This high consumption is linked with a surge in the number of opioid prescriptions for the treatment of chronic pain and a surge in opioid misuse and addiction. Opioid analgesics have a short duration of action, making necessary frequent administrations to provide extended analgesia. The use of prolonged-release formulations enables dosing intervals to be spaced out and drug blood levels to be stabilized, improving therapeutic compliance, and reducing the likelihood of developing addiction. However, these formulations contain higher doses of opioid analgesics which make them more susceptible to be manipulated. Hence, the most recent advances in pharmaceutical technology have been oriented towards the application of abuse deterrent technologies aiming to prevent their administration through alternative routes. Moreover, prolonged- release systems also play an essential role in the treatment of opioid addictions with the development of parenteral dosage forms capable of prolonging opioid release for months that help overcome one of the most important drawbacks in achieving treatment success, namely, patient compliance. We review herein the different prolonged-release opioid dosage forms currently approved in Europe and/or the United States for the treatment of pain and opioid dependence.

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“…4 For all these reasons, new formulations of extendedrelease buprenorphine (XR-BUP) have recently been developed and commercialized, offering a one-week, onemonth, or six-month treatment coverage to OUD subjects, through subcutaneous depot or implant formulations. 5 Two depot forms, ie Buvidal ® (Camurus ® , Sweden) and Sublocade ® (Indivior ® , USA), have been approved in different countries. Furthermore, an implant, Sixmo ® , has been approved in the USA and in Europe.…”

Section: Introductionmentioning

confidence: 99%

Factors of Interest in Extended-Release Buprenorphine: Comparisons Between Incarcerated and Non-Incarcerated Patients with Opioid Use Disorder

Chappuy¹,

Meroueh²,

Trojak³

et al. 2021

PPA

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Purpose Extended-release buprenorphine (XR-BUP) covers a range of formulations of buprenorphine-based treatments for opioid use disorder (OUD) that release the medication over a period of one week, one month, or six months. OUD is particularly prevalent among incarcerated populations, and previous findings have shown that incarcerated subjects were not less interested in XR-BUP than non-incarcerated subjects. However, no study has ever investigated whether the factors of interest in XR-BUP were similar in incarcerated and non-incarcerated populations. Patients and Methods We carried out post-hoc analyses using data from the “AMBRE” survey, which was conducted among 366 individuals with OUD, that were recruited in 68 French addiction settings, including six prison medical centers. The reasons for interest in XR-BUP were compared between incarcerated and non-incarcerated interviewees, using logistic regressions models, which provided raw and adjusted odds ratios (aORs) and 95% confidence intervals (95% CI). Adjustment variables were gender, age category, level of education, and type of current medication for OUD, respectively. Results Data from 317 participants (ie, 221 non-incarcerated, and 96 incarcerated individuals) were included in the analyses. Adjusted comparisons found that “no longer taking a daily treatment” (aOR= 2.91; 95% CI= 1.21–6.98) and “having a more discreet medication” (aOR= 1.76; 95% CI= 1.01–3.10) were reasons that appealed more to incarcerated participants than to non-incarcerated ones. On the other hand, the potential reduction of withdrawal symptoms (aOR= 0.54; 95% CI= 0.29–0.99) or the risk of misuse (aOR= 0.56; 95% CI= 0.34–0.94) associated with XR-BUP treatment were considered more important by non-incarcerated individuals than by incarcerated ones. Conclusion Incarcerated interviewees were interested in XR-BUP for different reasons than those outside prison. In particular, incarcerated patients were more interested in practicability and discretion features, and less in improving recovery or reducing misuse than non-incarcerated patients.

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Prolonged-release buprenorphine formulations: Perspectives for clinical practice

Cited by 29 publications

References 27 publications

Using Microdosing to Induct Patients Into a Long-Acting Injectable Buprenorphine Depot Medication in Low Threshold Community Settings: A Case Study

Using Microdosing to Induct Patients Into a Long-Acting Injectable Buprenorphine Depot Medication in Low Threshold Community Settings: A Case Study

Extended-Release Delivery Systems of Opioids: Analgesia and Dependence

Factors of Interest in Extended-Release Buprenorphine: Comparisons Between Incarcerated and Non-Incarcerated Patients with Opioid Use Disorder

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