Ling W, Nadipelli VR, Solem CT, Ronquest NA, Yeh YC, Learned SM, Mehra V, Heidbreder C. Patient-centered outcomes in participants of a buprenorphine monthly depot (BUP-XR) double-blind, placebo-controlled, multicenter, phase 3 study. J Addict Med. 2019 Mar 4. doi: 10.1097/ADM.0000000000000517.

OBJECTIVE: Opioid use disorder (OUD) is associated with physical, social, psychological, and economic burden. This analysis assessed the effects of RBP-6000, referred to as BUP-XR (extended-release buprenorphine), a subcutaneously injected, monthly buprenorphine treatment for OUD compared with placebo on patient-centered outcomes measuring meaningful life changes.

METHODS: Patient-centered outcomes were collected in a 24-week, phase 3, placebo-controlled study assessing the efficacy, safety, and tolerability of BUP-XR 300/300mg (6300 mg) and 300/100mg (2300mg followed by 4100 mg) injections in treatment-seeking participants with moderate-to-severe OUD. Measures included the EQ-5D-5L, SF-36v2, Medication Satisfaction Questionnaire, employment/insurance status, and healthcare resource utilization (HCRU). Changes from baseline to end of study were compared across treatment arms, using mixed models for repeated measures.

RESULTS: Participants receiving BUP-XR (n¼389) versus placebo (n¼98) had significantly greater changes from baseline on the EQ- 5D-5L index (300/300 mg: difference¼0.0636, P¼0.003), EQ-5D- 5L visual analog scale (300/300 mg: difference¼5.9, P¼0.017; 300/100 mg: difference¼7.7, P¼0.002), and SF-36v2 physical component summary score (300/300 mg: difference¼3.8, P<0.001; 300/100 mg: difference¼3.2, P¼0.002). Satisfaction was significantly higher for participants receiving BUP-XR 300/ 300mg (88%, P<0.001) and 300/100mg (88%, P<0.001) than placebo (46%). Employment and percentage of insured participants increased by 10.8% and 4.1% with BUP-XR 300/300mg and 10.0% and 4.7% with 300/100mg but decreased by 12.6% and 8.4% with placebo. Participants receiving BUP-XR compared with placebo had significantly fewer hospital days per person-year observed.

CONCLUSIONS: These results show the feasibility of measuring patient-centered life changes in substance use disorder clinical studies. Participants receiving up to 6 monthly injections of BUPXR, compared with placebo, reported better health, increased medication satisfaction, increased employment, and decreased healthcare utilization.

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