Subcutaneous buprenorphine effective in curbing cravings, easing withdrawal in OUD

Key takeaways:

• The study included 227 individuals with OUD given CAM2038 either on weekly or monthly basis.
• The treatment was effective at curbing cravings and withdrawals and was found to be well-tolerated.

MIAMI BEACH, Fla. — Treatment with subcutaneous buprenorphine on a weekly or monthly basis eased cravings and withdrawals in those with opioid use disorder, per data from the American Society of Clinical Psychopharmacology annual meeting.

“Patients with opioid use disorder are an underserved population where there are certain formulations that work well for some people but not for others,” Natalie K. Budilovsky-Kelley, PharmD, director of medical affairs at Braeburn, a Pennsylvania-based pharmaceutical company that focuses on opioid use treatments, told Healio. “This is another tool in the toolbox for clinicians and patients.”

Given prior research that has established safety and efficacy of buprenorphine administered in multiple forms to treat OUD, the researchers sought to examine the effects of weekly and monthly doses of CAM2038, a novel form of subcutaneous buprenorphine on those with moderate to severe OUD.

Their post-hoc analysis evaluated CAM2038 in 227 individuals with OUD aged 18 to 65 years . The participants were divided into two groups, one treated with sublingual buprenorphine, a buprenorphine/naloxone combination (n = 190; mean age 41.3 years; 62.6% male), and a second group of those who sought to initiate treatment with no prior involvement with the drug for at least 60 days (n = 37; mean age 41.8 years; 64.9% male). Those in the latter group were given CAM2038 on a weekly basis, while those in the former group were transitioned to the new therapeutic either weekly or monthly based on dosing from previous treatment. Doses in the weekly group ranged from 8 mg to 32 mg, and those in the monthly group ranged from 64 to 160 mg.

Per clinical guidelines, flexible and individualized doses of CAM2038 as well as alterations in visit frequency were left to the investigator’s judgment, in consultation with the individual, during the treatment phase. Urine samples were collected at time of visit based on weekly or monthly administration.

According to results, 59% of study participants used heroin as their opioid of choice (51% of those converted from sublingual administration, 100% of newly treated individuals).

In the transition group, 50 of 190 (26.3%) converted to and remained on CAM2038 on a weekly basis, 63 of 190 (33.2%) converted to weekly CAM2038 and then transitioned to monthly, while 77 of 190 (40.5%) converted to monthly administration.

Among the new-to-treatment group, 25 of 37 began and remained on CAM2038 on a weekly basis with the remaining 12 transitioning from weekly to monthly administration.

Data additionally showed that, for all study participants, higher doses of CAM2038 on a weekly basis led to lower Clinical Opioid Withdrawal Scale scores compared with higher doses on a monthly basis, with treatment effective in suppressing cravings and withdrawal at all doses.

CAM2038 was generally well-tolerated, with treatment-emergent adverse events occurring in up to 5% of study participants and the most common reported were pain, swelling or arythema at the injection site as well as headache, nausea and nasopharyngitis.

“There is some research that suggests patients on higher doses of buprenorphine do better,” Budilovsky-Kelley said. “We looked at withdrawal and cravings, and saw that in increasing doses, outcomes turned out better.”