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Prolonged-release buprenorphine formulations: Perspectives for clinical practice.

Mathieu Chappuy1, Benoit Trojak2, Philippe Nubukpo3

  • 1Service universitaire d'addictologie de Lyon (SUAL), centre hospitalier Le Vinatier, 69500 Bron, France; Service d'addictologie, groupement hospitalier centre, Hospices Civils de Lyon, 69003 Lyon, France; Centre de soins, d'accompagnement et de prévention en addictologie, groupement hospitalier nord, Hospices Civils de Lyon, 69004 Lyon, France.

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New prolonged-release buprenorphine formulations offer improved safety and convenience for opioid use disorder treatment. These long-acting options aim to reduce risks associated with daily sublingual buprenorphine, enhancing patient comfort and adherence.

Keywords:
BuprenorphineOpiatesOpioid dependenceProlonged-releaseSubstitution

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Area of Science:

  • Pharmacology
  • Addiction Medicine
  • Drug Delivery Systems

Background:

  • Buprenorphine and methadone are primary opioid agonist treatments for opioid use disorder (OUD).
  • Sublingual buprenorphine, while effective, presents challenges like daily intake, potential misuse, and withdrawal risks.
  • New prolonged-release buprenorphine (PRB) formulations aim to improve patient comfort and treatment safety.

Purpose of the Study:

  • To review the technical features, efficacy, and safety of new prolonged-release buprenorphine formulations.
  • To explore patient and professional expectations and concerns regarding these novel treatments.
  • To compare PRB options with traditional sublingual buprenorphine.

Main Methods:

  • Narrative review of scientific literature and regulatory texts.
  • Analysis of data on subcutaneous implants and depot injections.
  • Inclusion of patient and professional perspectives on PRB use.

Main Results:

  • Three PRB formulations exist: a 6-month subcutaneous implant (Sixmo®/Probuphine®) and two monthly depot injections (Sublocade®, Buvidal®/Brixadi®).
  • PRBs offer potential benefits for stabilized patients, reducing daily intake burdens and addressing risks of treatment dropout.
  • Concerns include potential coercive use of long-acting formulations, but overall user and professional reception is positive for specific patient groups.

Conclusions:

  • Prolonged-release buprenorphine formulations represent a significant advancement in OUD management.
  • These new options may enhance treatment adherence and safety, particularly for patients struggling with daily dosing or at risk of relapse.
  • Further research and careful implementation are needed to address patient concerns and optimize PRB utilization.