96-week retention in treatment with extended-release subcutaneous buprenorphine depot injections among people with opioid dependence: Extended follow-up after a single-arm trial

Michael Farrell; Jeyran Shahbazi; Mark Chambers; Marianne Byrne; Jaleh Gholami; Emma Zahra; Jason Grebely; Nicholas Lintzeris; Briony Larance; Robert Ali; Suzanne Nielsen; Adrian Dunlop; Gregory J Dore; Michael McDonough; Mark Montebello; Rob Weiss; Craig Rodgers; Jon Cook; Louisa Degenhardt; CoLAB study team

doi:10.1016/j.drugpo.2024.104390

96-week retention in treatment with extended-release subcutaneous buprenorphine depot injections among people with opioid dependence: Extended follow-up after a single-arm trial

Int J Drug Policy. 2024 Mar 23:127:104390. doi: 10.1016/j.drugpo.2024.104390. Online ahead of print.

Authors

Michael Farrell¹, Jeyran Shahbazi², Mark Chambers², Marianne Byrne³, Jaleh Gholami², Emma Zahra², Jason Grebely⁴, Nicholas Lintzeris⁵, Briony Larance⁶, Robert Ali⁷, Suzanne Nielsen⁸, Adrian Dunlop⁹, Gregory J Dore⁴, Michael McDonough¹⁰, Mark Montebello¹¹, Rob Weiss¹², Craig Rodgers¹³, Jon Cook¹⁴, Louisa Degenhardt²; CoLAB study team

Affiliations

¹ National Drug and Alcohol Research Centre, UNSW, Australia. Electronic address: michael.farrell@unsw.edu.au.
² National Drug and Alcohol Research Centre, UNSW, Australia.
³ National Drug and Alcohol Research Centre, UNSW, Australia; The Kirby Institute, UNSW, Australia.
⁴ The Kirby Institute, UNSW, Australia.
⁵ Discipline of Addiction Medicine, University of Sydney, NSW, Australia; Drug and Alcohol Services, South East Sydney Local Health District, Surry Hills, NSW, Australia.
⁶ National Drug and Alcohol Research Centre, UNSW, Australia; School of Psychology, University of Wollongong, Wollongong, NSW, Australia.
⁷ National Drug and Alcohol Research Centre, UNSW, Australia; Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia.
⁸ National Drug and Alcohol Research Centre, UNSW, Australia; Monash Addiction Research Centre, Eastern Health Clinical School, Monash University Peninsula Campus, Frankston, Victoria, Australia.
⁹ Drug and Alcohol Clinical Services, Hunter New England Local Health District, Newcastle, NSW, Australia; Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia.
¹⁰ Drug and Alcohol Services South Australia, Adelaide, South Australia, Australia.
¹¹ National Drug and Alcohol Research Centre, UNSW, Australia; Discipline of Addiction Medicine, University of Sydney, NSW, Australia; Drug and Alcohol Services, North Sydney Local Health District, St Leonards, NSW, Australia.
¹² Frankston Healthcare, Frankston, Victoria, Australia.
¹³ Alcohol and Drug Service, St Vincent's Hospital, Darlinghurst NSW Australia.
¹⁴ Drug and Alcohol Clinical Advisory Service, Western Health, Victoria, Australia.

PMID: 38522175
DOI: 10.1016/j.drugpo.2024.104390

Abstract

Background: The most recent formulation of buprenorphine treatment is extended-release depot injections (BUP-XR) that are administered subcutaneously by health care professionals. This study aimed to observe treatment outcomes of BUP-XR delivered in standard practice during a 96-week follow-up period in a community setting.

Methods: This study is an extension of the CoLAB study, a prospective single-arm, multicentre, open label trial (N=100, 7 sites in Australia) among people with opioid dependence who received monthly injections of BUP-XR to evaluate the retention in treatment. Participants were followed for 96 weeks, comprising 48 weeks of the CoLAB study followed by a 48-week extension.

Results: Of 100 participants at baseline, 47 were retained on BUP-XR at 96 weeks. The median time retained on monthly depot was 90 weeks. Heroin use (adjusted OR=0.19, P=0.012) in the month prior to baseline was associated with lower odds of retention on BUP-XR. Older age at first opioid use (adjusted OR= 1.08, P=0.009) and longer duration in OAT at baseline (adjusted OR= 1.12, P=0.001) were associated with increased retention. Prevalence of past four-weeks opioid use was estimated at 4% at 96 weeks of treatment (prevalence 0.04, 95%CI: 0.00-0.11) compared to 15% at baseline. Quality of life and medication treatment satisfaction improved over time for those retained in treatment.

Conclusion: This is one of the few studies to describe long term (96 week) retention in treatment with BUP-XR in a community setting. It displayed retention rates with 47% of participants completing 96 weeks of treatment with BUP-XR. Patient reported outcomes suggest improvements in client wellbeing.

Funding: Indivior.

Keywords: Extended-release buprenorphine; Opioid dependence; Opioid dependence treatment; Retention.