Risk of Oral Health Problems in Adults With Opioid Use Disorder Treated With Transmucosal Buprenorphine

Area of Science:

• Oral health research
• Addiction medicine
• Pharmacovigilance

Background:

• US FDA issued warnings in early 2022 regarding oral health issues linked to transmucosal buprenorphine.
• Transmucosal buprenorphine formulations are commonly prescribed for opioid use disorder (OUD).
• Limited case-report evidence necessitated further investigation into this association.

Purpose of the Study:

• To assess the risk of adverse oral health outcomes in adults prescribed transmucosal buprenorphine for OUD.
• To provide data supporting or refuting the FDA's warning on buprenorphine-associated oral health problems.
• To quantify the association between transmucosal buprenorphine and new oral health diagnoses.

Main Methods:

• Retrospective cohort study using TriNetX claims data (2002-2019).
• Included adults with OUD, comparing those with ≥3 transmucosal buprenorphine prescriptions to a control group.
• Utilized weighted propensity score matching and Cox regression for up to 5-year follow-up.

Main Results:

• Study included 721,878 adults with OUD; 156,594 (21.7%) received buprenorphine.
• Buprenorphine group showed a 1.24-1.30 adjusted increased risk of new oral health diagnoses.
• Significant risk observed at both 1- and 5-year follow-up points (P < 0.001).

Conclusions:

• Claims data suggest an association between transmucosal buprenorphine and oral health problems in OUD patients.
• Highlights the need for prospective research and patient counseling on potential oral health risks.
• Emphasizes balancing risk awareness with continued access to evidence-based OUD treatment.