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Phase 3 Completed N=63 Randomized Quadruple-blind Treatment

Blinded Trial of Buprenorphine or Morphine in the Treatment of the Neonatal Abstinence Syndrome

Source: ClinicalTrials.gov NCT01452789 ↗
Enrolled (actual)
63
Serious AEs
3.2%
Results posted
Mar 2020
Primary outcomePrimary: Length of Treatment — 15; 28 days — p=<0.05
◆ Published Evidence
Highly cited
164citations · ~18 / year
Buprenorphine for the Treatment of the Neonatal Abstinence Syndrome.
The New England journal of medicine · 2017 · Open access · Likely link

Summary

The opioid neonatal abstinence syndrome (NAS) is a condition of withdrawal symptoms after utero exposure to opioids. In an open label Phase 1 trial sublingual buprenorphine was associated with a ~30% reduction length of treatment compared to standard of care morphine. Due to the subjective nature of the scoring instrument, efficacy in a blinded trial is needed to unequivocally establish the superiority of buprenorphine over morphine. The primary objective of the trial is to compare length of treatment using sublingual buprenorphine or oral morphine solution in the pharmacologic treatment of the NAS.

Linked Publications (2)

  • Buprenorphine for the Treatment of the Neonatal Abstinence Syndrome.
    The New England journal of medicine · 2017 · 164 citations · Open access · Likely link
  • Opioid treatment for opioid withdrawal in newborn infants.
    The Cochrane database of systematic reviews · 2021 · 35 citations · Open access · Likely link

Outcome Measures

OutcomeResultp-value
PRIMARY
Length of Treatment
15; 28 <0.05 sig
SECONDARY
Length of Hospitalization
21; 33 <0.05 sig
SECONDARY
Number of Patients Requiring Supplemental Phenobarbital Treatment.
5; 7 <0.05 sig
SECONDARY
Number of Participants With Adverse Events as a Measure of Safety and Tolerability
7; 8

Eligibility Criteria

Inclusion Criteria

  • ≥ 37 weeks gestation
  • Exposure to opiates in utero
  • Demonstration of signs and symptoms of neonatal abstinence syndrome requiring treatment

Exclusion Criteria

  • Major congenital malformations and/or intrauterine growth retardation
  • Medical illness requiring intensification of medical therapy. This includes, but is not limited to suspected sepsis requiring antibiotic therapy.
  • Hypoglycemia requiring treatment with intravenous dextrose.
  • Bilirubin >20 mg/dL (The need for phototherapy is not exclusionary)
  • Concomitant benzodiazepine or severe alcohol abuse , self-report of regular use of alcohol or of benzodiazepines use in the past 30 days, and/or receipt of benzodiazepines by prescription (as determined by self-report or intake urine) by the mother 30 days prior to birth,
  • Concomitant use of Cytrochrom (CYP) 3A inhibitors (erythromycin, clarithromycin, ketoconazole, itraconazole, HIV protease inhibitors) or inducers (rifampin, carbamazepine, phenobarbital) prior to initiation of NAS treatment
  • Seizure activity or other neurologic abnormality
  • Breast feeding
  • Inability of mother to give informed consent due to co-morbid psychiatric diagnosis
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT01452789) and the linked publication. Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication. Informational only — not medical advice.

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