The purpose of this study was to assess retention in treatment after induction with buprenorphine/naloxone (BNX) sublingual tablets compared with generic buprenorphine and after stabilization with BNX sublingual tablets compared with BNX film. Secondary objectives included assessment of treatment effects on opioid withdrawal symptoms, opioid cravings, and safety.
This prospective, randomized, multicenter, parallel-group, non-inferiority study was conducted at 43 centers in the United States from August 2013 to April 2014. A non-inferior design was used because both products contain the same active components, and it was considered unethical to include a placebo arm. The study comprised an induction phase of 2 days and a stabilization phase of 20 days, with study visits scheduled on Days 1, 2, 3, 4, 8, 15, and 22. Eligible opioid-dependent patients were randomly assigned within 14 days of screening to induction with either the BNX sublingual tablets or generic buprenorphine tablets for 2 days. On Day 3, patients initially allocated to buprenorphine were switched to BNX film, whereas those allocated to BNX sublingual tablets continued on the same treatment. On Day 15, patients receiving BNX film were switched to BNX sublingual tablets, and those on BNX sublingual tablets were switched to BNX film. At the final study visit on Day 22, patients were offered the option of continuing in an open-label follow-up study of BNX sublingual tablets.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
759
Buprenorphine/naloxone sublingual tablets
Buprenorphine/naloxone sublingual film
Buprenorphine sublingual tablets
Unnamed facility
Primary Endpoints of Retention in Treatment at Days 3 and 15
Retention rates (number of patients retained) for the primary efficacy endpoints of retention in treatment at Days 3 and 15, which was defined as the number of patients who received treatment on Days 3 and 15.
Time frame: Day 3 and Day 15
Clinical Opiate Withdrawal Scale (COWS) Scores: Induction
Absolute ± mean standard deviation values for COWS total scores at baseline; 0.5 h, 1.5 h, 3 h, and 6 h post dose on Day 1, and Day 2; COWS scores range from 0-48, with a lower score being more favorable
Time frame: Days 1 and 2
COWS Total Scores: Stabilization/Maintenance
Absolute ± mean standard deviation values for COWS total scores at Days 3, 4, 8, 15, and 22; COWS scores range from 0-48, with a lower score being more favorable
Time frame: Days 3 through 22
Subjective Opiate Withdrawal Scale (SOWS) Scores: Induction
Absolute ± mean standard deviation values for SOWS total scores at baseline, 0.5 h, 1.5 h, 3 h, and 6 h post dose on Day 1, and Day 2; SOWS score ranges from 0-64, with a lower score being more favorable
Time frame: Days 1 and 2
SOWS Total Scores: Stabilization/Maintenance
Absolute ± mean standard deviation values for SOWS total scores on Days 2, 3, 4, 8, 15, and 22; SOWS scores ranged from 0-64, with a lower score being more favorable
Time frame: Days 3 through 22
Visual Analog Scale (VAS) Cravings: Induction
Absolute mean ± standard deviation values for VAS cravings at baseline, 0.5 h, 1.5 h, 3 h, and 6 post dose on Day 1, and Day 2; the VAS craving scores range from 0 ("no cravings") to 100 ("most intense craving I have ever had")
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Baldwin County, Alabama, United States
Unnamed facility
Houston County, Alabama, United States
Unnamed facility
Maricopa, Arizona, United States
Unnamed facility
Beverly Hills, California, United States
Unnamed facility
Los Angeles County, California, United States
Unnamed facility
Riverside County, California, United States
Unnamed facility
San Diego County, California, United States
Unnamed facility
Broward County, Florida, United States
Unnamed facility
Colombia County, Florida, United States
Unnamed facility
Duval County, Florida, United States
...and 26 more locations
Time frame: Days 1 and 2
VAS Craving Scores: Stabilization/Maintenance
Absolute mean ± standard deviation values for VAS cravings scores on Days 3, 4, 8, 15, and 22; the VAS craving scores range from 0 ("no cravings") to 100 ("most intense craving I have ever had")
Time frame: Days 3 through 22