Buprenorphine exposure levels to optimize treatment outcomes in opioid use disorder
The severity of the ongoing opioid crisis, recently exacerbated by the COVID-19 pandemic, emphasizes the importance for individuals suffering from opioid use disorder (OUD) to have access to and receive efficacious, evidence-based treatments. Optimal treatment of OUD should aim at blocking the effec...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-11-01
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| Series: | Frontiers in Pharmacology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2022.1052113/full |
| _version_ | 1811220004297768960 |
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| author | Celine M. Laffont Eliford Ngaimisi Mathangi Gopalakrishnan Vijay Ivaturi Malcolm Young Mark K. Greenwald Christian Heidbreder |
| author_facet | Celine M. Laffont Eliford Ngaimisi Mathangi Gopalakrishnan Vijay Ivaturi Malcolm Young Mark K. Greenwald Christian Heidbreder |
| author_sort | Celine M. Laffont |
| collection | DOAJ |
| description | The severity of the ongoing opioid crisis, recently exacerbated by the COVID-19 pandemic, emphasizes the importance for individuals suffering from opioid use disorder (OUD) to have access to and receive efficacious, evidence-based treatments. Optimal treatment of OUD should aim at blocking the effects of illicit opioids while controlling opioid craving and withdrawal to facilitate abstinence from opioid use and promote recovery. The present work analyses the relationship between buprenorphine plasma exposure and clinical efficacy in participants with moderate to severe OUD using data from two clinical studies (39 and 504 participants). Leveraging data from placebo-controlled measures assessing opioid blockade, craving, withdrawal and abstinence, we found that buprenorphine plasma concentrations sustained at 2–3 ng/ml (corresponding to ≥70% brain mu-opioid receptor occupancy) optimized treatment outcomes in the majority of participants, while some individuals (e.g., injecting opioid users) needed higher concentrations. Our work also included non-linear mixed effects modeling and survival analysis, which identified a number of demographic, genetic and social factors modulating treatment response and retention. Altogether, these findings provide key information on buprenorphine plasma levels that optimize clinical outcomes and increase the likelihood of individual treatment success. NLM identifiers: NCT02044094, NCT02357901. |
| first_indexed | 2024-04-12T07:35:12Z |
| format | Article |
| id | doaj.art-f20f95ba52094210b8eddc063199a43d |
| institution | Directory Open Access Journal |
| issn | 1663-9812 |
| language | English |
| last_indexed | 2024-04-12T07:35:12Z |
| publishDate | 2022-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pharmacology |
| spelling | doaj.art-f20f95ba52094210b8eddc063199a43d2022-12-22T03:41:58ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122022-11-011310.3389/fphar.2022.10521131052113Buprenorphine exposure levels to optimize treatment outcomes in opioid use disorderCeline M. Laffont0Eliford Ngaimisi1Mathangi Gopalakrishnan2Vijay Ivaturi3Malcolm Young4Mark K. Greenwald5Christian Heidbreder6Indivior Inc., North Chesterfield, VA, United StatesCenter for Translational Medicine, University of Maryland, Baltimore, MD, United StatesCenter for Translational Medicine, University of Maryland, Baltimore, MD, United StatesCenter for Translational Medicine, University of Maryland, Baltimore, MD, United StatesIndivior Inc., North Chesterfield, VA, United StatesDepartment of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United StatesIndivior Inc., North Chesterfield, VA, United StatesThe severity of the ongoing opioid crisis, recently exacerbated by the COVID-19 pandemic, emphasizes the importance for individuals suffering from opioid use disorder (OUD) to have access to and receive efficacious, evidence-based treatments. Optimal treatment of OUD should aim at blocking the effects of illicit opioids while controlling opioid craving and withdrawal to facilitate abstinence from opioid use and promote recovery. The present work analyses the relationship between buprenorphine plasma exposure and clinical efficacy in participants with moderate to severe OUD using data from two clinical studies (39 and 504 participants). Leveraging data from placebo-controlled measures assessing opioid blockade, craving, withdrawal and abstinence, we found that buprenorphine plasma concentrations sustained at 2–3 ng/ml (corresponding to ≥70% brain mu-opioid receptor occupancy) optimized treatment outcomes in the majority of participants, while some individuals (e.g., injecting opioid users) needed higher concentrations. Our work also included non-linear mixed effects modeling and survival analysis, which identified a number of demographic, genetic and social factors modulating treatment response and retention. Altogether, these findings provide key information on buprenorphine plasma levels that optimize clinical outcomes and increase the likelihood of individual treatment success. NLM identifiers: NCT02044094, NCT02357901.https://www.frontiersin.org/articles/10.3389/fphar.2022.1052113/full(extended-release) buprenorphineopioid blockadewithdrawalcravingexposure-responseopioid use disorder |
| spellingShingle | Celine M. Laffont Eliford Ngaimisi Mathangi Gopalakrishnan Vijay Ivaturi Malcolm Young Mark K. Greenwald Christian Heidbreder Buprenorphine exposure levels to optimize treatment outcomes in opioid use disorder Frontiers in Pharmacology (extended-release) buprenorphine opioid blockade withdrawal craving exposure-response opioid use disorder |
| title | Buprenorphine exposure levels to optimize treatment outcomes in opioid use disorder |
| title_full | Buprenorphine exposure levels to optimize treatment outcomes in opioid use disorder |
| title_fullStr | Buprenorphine exposure levels to optimize treatment outcomes in opioid use disorder |
| title_full_unstemmed | Buprenorphine exposure levels to optimize treatment outcomes in opioid use disorder |
| title_short | Buprenorphine exposure levels to optimize treatment outcomes in opioid use disorder |
| title_sort | buprenorphine exposure levels to optimize treatment outcomes in opioid use disorder |
| topic | (extended-release) buprenorphine opioid blockade withdrawal craving exposure-response opioid use disorder |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2022.1052113/full |
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