Switching opioid-dependent patients in substitution treatment from racemic methadone, levomethadone and buprenorphine to slow-release oral morphine - Analysis of the switching process in routine care
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Switching opioid-dependent patients in substitution treatment from racemic methadone, levomethadone and buprenorphine to slow-release oral morphine - Analysis of the switching process in routine care. / Baschirotto, Cinzia; Lehmann, Kirsten; Kuhn, Silke; Reimer, Jens; Verthein, Uwe.
in: J PHARMACOL SCI, Jahrgang 144, Nr. 1, 09.2020, S. 9-15.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Switching opioid-dependent patients in substitution treatment from racemic methadone, levomethadone and buprenorphine to slow-release oral morphine - Analysis of the switching process in routine care
AU - Baschirotto, Cinzia
AU - Lehmann, Kirsten
AU - Kuhn, Silke
AU - Reimer, Jens
AU - Verthein, Uwe
N1 - Copyright © 2020 The Authors. Production and hosting by Elsevier B.V. All rights reserved.
PY - 2020/9
Y1 - 2020/9
N2 - Since 2015 slow-release oral morphine (SROM) is approved for opioid substitution treatment (OST) in Germany. The SROMOS study (efficacy and tolerability of slow-release oral morphine in opioid substitution treatment) evaluates the efficacy and safety of SROM in routine care. This article describes the switching process from racemic methadone, levomethadone and buprenorphine to SROM. Between July 2016 and November 2017 180 patients in 23 study centers in Germany were included in the prospective, non-interventional, naturalistic observational study. Patients were already in OST and switched from a previous medication to SROM. The switching process was analyzed during a period of fourteen days. Data were available for 169 participants. The switching process had a different progression depending on premedication and pre dosage. On the fourteenth day of SROM treatment patients switched from racemic methadone took an average dosage of 922.2 mg/day, from levomethadone 801.0 mg/day and from buprenorphine 626.7 mg/day. Average conversion ratio racemic methadone to SROM was 1:11.8, levomethadone to SROM 1:17.4 and buprenorphine to SROM 1:58.0. This study provides the first data on the switching process from buprenorphine to SROM. Average dose ratio racemic methadone to SROM on the fourteenth day of treatment was considerably higher than recommended in the prescribing information.
AB - Since 2015 slow-release oral morphine (SROM) is approved for opioid substitution treatment (OST) in Germany. The SROMOS study (efficacy and tolerability of slow-release oral morphine in opioid substitution treatment) evaluates the efficacy and safety of SROM in routine care. This article describes the switching process from racemic methadone, levomethadone and buprenorphine to SROM. Between July 2016 and November 2017 180 patients in 23 study centers in Germany were included in the prospective, non-interventional, naturalistic observational study. Patients were already in OST and switched from a previous medication to SROM. The switching process was analyzed during a period of fourteen days. Data were available for 169 participants. The switching process had a different progression depending on premedication and pre dosage. On the fourteenth day of SROM treatment patients switched from racemic methadone took an average dosage of 922.2 mg/day, from levomethadone 801.0 mg/day and from buprenorphine 626.7 mg/day. Average conversion ratio racemic methadone to SROM was 1:11.8, levomethadone to SROM 1:17.4 and buprenorphine to SROM 1:58.0. This study provides the first data on the switching process from buprenorphine to SROM. Average dose ratio racemic methadone to SROM on the fourteenth day of treatment was considerably higher than recommended in the prescribing information.
KW - Administration, Oral
KW - Adult
KW - Buprenorphine/administration & dosage
KW - Delayed-Action Preparations/administration & dosage
KW - Dose-Response Relationship, Drug
KW - Drug Administration Schedule
KW - Drug Substitution/methods
KW - Female
KW - Humans
KW - Male
KW - Methadone/administration & dosage
KW - Middle Aged
KW - Morphine/administration & dosage
KW - Opiate Substitution Treatment/methods
KW - Opioid-Related Disorders/drug therapy
KW - Treatment Outcome
KW - Young Adult
U2 - 10.1016/j.jphs.2020.06.004
DO - 10.1016/j.jphs.2020.06.004
M3 - SCORING: Journal article
C2 - 32586692
VL - 144
SP - 9
EP - 15
JO - J PHARMACOL SCI
JF - J PHARMACOL SCI
SN - 1347-8613
IS - 1
ER -
