Cognitive performance of patients with opioid use disorder transitioned to extended-release injectable naltrexone from buprenorphine: Post hoc analysis of exploratory results of a phase 3 randomized controlled trial

• DOI: 10.1016/j.addbeh.2020.106538
• Publication Date: 2020-07-03T15:52:34Z
• Authors: Thomas Kosten; Efrat Aharonovich; Narinder Nangia; Abigail Zavod; Sarah C. Akerman; Maria Lopez-Bresn...; Maria A. Sullivan
• Keywords: Post-hoc analysis

Opioid use disorder (OUD) is associated with cognitive dysfunction. Understanding how pharmacotherapy may affect cognition an important treatment consideration. This was a hybrid residential-outpatient, randomized trial assessing transition regimens (naltrexone/buprenorphine [NTX/BUP] vs placebo-NTX/buprenorphine [PBO-N]/BUP) to extended-release naltrexone (XR-NTX) in patients OUD seeking BUP discontinuation. Cognition assessed at baseline, Day 22 (XR-NTX 14), and 36 28) using range of measures (Brief Assessment Symbol Coding test, Controlled Oral Word Association Task, Wechsler Memory Scale-III Spatial Span Continuous Performance Test, Test Attentional Performance). Pre-specified exploratory analyses compared groups. Post hoc were treatment-arm–independent overall by baseline dose (<8 mg/day [low-dose] or 8 [higher-dose]). Baseline similar between NTX/BUP PBO-N/BUP groups low-dose higher-dose There improvements several outcomes relative for the population, but no differences observed. Participants entering study on showed 5 7 outcomes; participants generally did not show outcomes. Improvements most domains from XR-NTX, particularly mg/day) BUP. These be due discontinuation BUP, both.