持续释放的纳尔特雷克松用于阿片类药物依赖
Hege Kornør1, Philipp Paul K Lobmaier2, Nikolaj Kunøe3,4
1Norwegian Centre for Sports and Mental Health, Oslo, Norway.
The Cochrane database of systematic reviews
|May 9, 2025
概括
持续释放的纳尔特雷克森 (SRN) 在阿片类药物依赖治疗中显示出混合的结果. 虽然它与通常治疗相比减少了非法阿片类药物的使用,但它可能会增加使用和不良事件与阿片类药物激发剂相比,与安慰剂或口服纳尔特雷克松相比有不确定的好处.
科学领域:
- 药理学和成医学 药理学和成医学
- 基于证据的医学基于证据的医学.
- 临床试验分析
背景情况:
- 阿片类药物依赖是一种慢性疾病,具有显著的死亡率和心理社会负担.
- 持续释放的纳尔特雷克松 (SRN) 提供了一种长效阿片类药物抗剂治疗选择.
- SRN配方包括每月注射和更长时间的植入物 (长达六个月).
研究的目的:
- 系统地评估持续释放纳尔特雷 (SRN) 治疗阿片类药物依赖的益处和危害.
- 综合来自随机对照试验的证据,将SRN与各种控制组进行比较.
主要方法:
- 综合的数据库搜索 (2007-2023) 确定了22个随机对照试验 (3416名参与者).
- 研究比较了可注射或可植入的SRN与阿片类激素治疗,口服纳尔特雷克松,安慰剂,常规治疗或心理社会干预.
- 主要结局包括非法阿片类药物使用,治疗保留,可接受性和不良事件,使用元分析和GRADE确定性评估进行分析.
主要成果:
- 与常规治疗相比,SRN显著减少了非法阿片类药物使用 (高确定性证据) 和可能减少严重不良事件 (中等确定性证据).
- 与阿片类药物激动剂治疗相比,SRN可能会略微增加非法阿片类药物使用和严重不良事件 (低至中等确定性).
- 对SRN与口服纳尔特雷或安慰剂的证据显示出混合的结果,通常在治疗保留和可接受性方面确定性或不确定性很低.
结论:
- 与通常治疗相比,持续释放的纳尔德在减少非法阿片类药物使用和潜在的严重不良事件方面表现出有效性.
- 有证据表明,SRN在非法阿片类药物使用和不良事件方面可能比阿片类激素治疗效率低,与口服纳尔特雷克松或安慰剂相比,相对益处不确定.
- 存在重大研究缺口,需要更大,更高质量的研究,对不同配方,长期结果和包括合成阿片类药物使用者在内的不同人群的调查.
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