在使用芬太尼尔的住院患者中,布普伦诺芬导致急性戒断
Ashish P Thakrar1,2, Paul J Christine3, Andrew Siaw-Asamoah4
1Division of General Internal Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia.
JAMA network open
|September 27, 2024
概括
在开始治疗阿片类药物使用障碍的患者中,有11.5%的患者出现了布普伦诺芬急性戒断 (PW). 更高的BMI和更高的尿液芬太尼度与PW的几率增加有关.
科学领域:
- 药理学 药理学是指药理学的学科.
- 成 药物 药物 药物 药物
- 临床研究 临床研究
背景情况:
- 布普伦诺芬是一种安全有效的治疗阿片类药物使用障碍 (OUD).
- 在布普伦诺芬启动期间戒除阿片类药物可能会对治疗的延续产生负面影响.
- 芬太尼在非法毒品供应中的流行引起了人们对布普伦诺啡导致的戒断 (PW) 的担忧.
研究的目的:
- 估计住院患者在布普伦诺芬启动期间PW的发生率.
- 在这个患者群体中确定与PW相关的因素.
主要方法:
- 在3所学术医院进行了回顾性队列研究.
- 包括患有OUD的成年人接受布普伦诺芬启动 (≥2毫克口下) 临床阿片类戒断量表 (COWS) 得分≥8.8.
- 评估PW发生率和因素,包括戒断严重程度,布普伦诺芬剂量,BMI和尿液芬太尼度.
主要成果:
- 整体PW发生率为11.5% (26/226名患者).
- 患有PW的患者经历了COWS平均得分增加9分.
- 较高的BMI (≥30 vs. <25) 和更高的尿芬太尼度 (≥200 vs. <20 ng/mL) 与PW有显著的关联.
结论:
- 布普伦诺芬急性戒断影响超过10%的患者在医院开始治疗.
- 较高的BMI和尿液芬太尼度升高是PW的危险因素.
- 需要进一步的研究来证实PW率和生物累积芬太尼的作用.
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