Comparison of naltrexone implant and oral buprenorphine-naloxone in the treatment of opiate use disorder.

Abstract

We aimed to compare the effectiveness of extended-release naltrexone (XR-NTX) implant and sublingual buprenorphine-naloxone (BUP-NX) in relapse prevention in opiate use disorder (OUD). Medical records of 400 patients who were treated for OUD between 2016 and 2020 were retrospectively evaluated concerning sociodemographic and clinical characteristics and abstinence duration with either BUP-NX (192 patients) or XR-NTX (208 patients) as maintenance treatments. The median age of patients using BUP-NX was 25.00, and the median age of patients using XR-NTX was 25.50 (p=.785). The ratio of female patients in the BUP-NX group and the XR-NTX group was 7.3% (n=14) and 6.7% (n=14), respectively. A significantly higher abstinence time was observed in the BUP-NX group (median=4months) than in the XR-NTX group (median=3months) (p=.015). Liver function tests were within the normal ranges at the three time points, which were just before the beginning and in the first and third months of treatment. These findings suggest that BUP-NX might be more effective than XR-NTX in preventing relapse in OUD and both drugs are safe for the liver. Prospective randomized studies are needed to replicate our results.