Wheeler A, Ling W, Nadipelli V, Ronquest N, Aldridge A, Solem C, Peiper N, Learned S, Heidbreder C. Recovery from opioid use disorder post-monthly buprenorphine extended release treatment: 12-month longitudinal outcomes. Poster presented at the Academy of Managed Care Pharmacy (AMCP) Nexus Conference; October 29, 2019. National Harbor, MD. [abstract] J Manag Care Spec Pharm. 2019 Oct; 25(10-a):S14. doi: 10.18553/jmcp.2019.25.10-a.s1.

BACKGROUND: The RECOVER (Remission from Chronic Opioid Use: Studying Environmental and SocioEconomic Factors on Recovery, NCT03604861) study explores outcomes in people with opioid use disorder (OUD) who initiated their recovery through participation in a Phase III clinical program of buprenorphine extended-release monthly injections (BUP-XR).

OBJECTIVE: To report cumulative and past-week opioid abstinence during the first 12 months of the observational window.

METHODS: Participants could enroll in RECOVER after completing or discontinuing participation in a BUP-XR Phase III program, comprising a double-blind, randomized, placebo-controlled study (NCT02357901) and an open-label safety study (NCT02510014). Data, collected every 3 months, comprise urine drug screens (UDS) and self-administered assessments on past week, past month, and past 6-month opioid use.

RESULTS: 50.8% of the 425 RECOVER participants self-reported abstinence for 12 months following their last study injection; 20.3% reported receiving pharmacotherapy for a substance use disorder. Past-week, self-reported opioid abstinence was noted on 68.0% of assessments. After adjustment, 12-month vs ≤2-month BUP-XR treatment duration remained a significant predictor of opioid abstinence over the 12-month period (75.3% vs 24.1%; P=0.001). Self-reported abstinence models suggested that the adjusted likelihood of abstinence at 12 months was 82.1% for those who stayed on BUP-XR for 12 months, 70.8% for 6-11 months, 48.8% for 3-5 months, and 58.6% for ≤2 months. When combining self-reported past-week abstinence with UDS outcomes, the adjusted likelihood of past-week abstinence was associated with duration of BUP-XR treatment.

CONCLUSIONS: Twelve months after RECOVER enrollment, half of participants self-reported complete abstinence, despite the low prevalence of additional pharmacologic OUD treatments. Longer BUP-XR treatment durations were associated with higher rates of opioid abstinence over 12 months and the past week. These findings provide important insights into understanding the role of novel pharmacologic treatments in supporting a patient’s recovery.

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