Characteristics of patients who are initiated on long-acting buprenorphine (Buvidal®) in France: A retrospective cross-sectional study - 25/10/24

Doi : 10.1016/j.therap.2024.09.003

Alice Deschenau ^a, Benoit Trojak ^b,^c, Georges Brousse ^d,^e, Lisa Blecha ^f, Julien Azuar ^g, Mathieu Chappuy ^h, Benjamin Touchon ⁱ, Margaux Kosim ^i,^j, Benjamin Rolland ^h,^k,^l,⁎
^a Service addictions, GH Paul-Guiraud, 94806 Villejuif, France
^b Service hospitalo-universitaire d’addictologie, CHU Dijon Bourgogne, 21000 Dijon, France
^c Inserm U1093, UFR STAPS, université de Bourgogne, 21000 Dijon, France
^d Service psychiatrie et addictologie de l’adulte CMP B, centre hospitalier universitaire (CHU), 63000 Clermont-Ferrand, France
^e Unité de formation et de recherche (UFR) médecine, université Clermont 1, 63000 Clermont-Ferrand, France
^f Hôpital Paul-Brousse, Assistance publique–Hôpitaux de Paris, 94806 Villejuif, France
^g Département de psychiatrie et de médecine addictologique, site Lariboisière Fernand-Widal, GHU AP-HP Nord–Université Paris Cité, AP-HP, 75000 Paris, France
^h Hospices civils de Lyon, 69000 Lyon, France
ⁱ Consultations de médecine-Alcoologie PASS, Assistance publique–Hôpitaux de Paris, GHU Sorbonne Université, Hôpital Pitié-Salpêtrière, 75000 Paris, France
^j Camurus SAS, 75000 Paris, France
^k Service universitaire d’addictologie de Lyon (SUAL), CH Le Vinatier, 69500 Bron, France
^l Équipe PSR², CRNL, UMR 5292 CNRS/1028 Inserm - université Lyon 1, 69500 Bron, France

^⁎Corresponding author. SUAL, pôle MOPHA, CH Le Vinatier, 95, boulevard Pinel, 69500 Bron, France.SUAL, pôle MOPHA, CH Le Vinatier95, boulevard PinelBron69500France

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Friday 25 October 2024

Summary

Aim

The long-acting buprenorphine Buvidal® is a recent type of opioid agonist treatment (OAT) used for opioid use disorder (OUD). It was initially suggested to preferentially use Buvidal® for specific OUD populations, including people in prison, or patients in recovery and on sublingual buprenorphine. We conducted a national study to examine whether the profile of patients treated with Buvidal® in France matched these initial recommendations.

Methods

A retrospective cross-sectional study was conducted in 13 national addiction centers (outside prison), using the individual medical records of patients initiated on Buvidal®. Baseline characteristics were collected and described, including sociodemographic features, comorbid medical conditions, concurrent substance use and prescription drug misuse, and OAT features before Buvidal® initiation, respectively.

Results

In total 101 patients (72.3% males, mean age 43.9±11.3years) were identified, which corresponded to one sixth of all patients treated with Buvidal® in France at the time of the study. Of them, 36 (36.4%) of them were professionally active, 35 (35.4%) were durably inactive, and the rest in an intermediary situation. Furthermore, 90 (90.0%) patients had at least one medical comorbidity (all types), and 83 (83.0%) at least one psychiatric comorbidity. Most frequent non-psychiatric comorbidities were chronic pain (n=20, 20.0%) and chronic viral infection (n=16, 17.8%). Current use of psychoactive substances included cocaine and crack (n=43, 42.6%), heroin (n=19, 18.8%), but also misuse of prescription drugs (n=20, 20%), mainly opioid analgesics. Moreover, 99 (98.0%) patients had an OAT before Buvidal® initiation, including 7 (8.1%) patients on methadone.

Conclusion

The profile of patients initiated on Buvidal® in France was extremely similar to that of patients treated for OUD in France, either in terms of social or clinical features. While initial recommendations essentially underlined the interest of Buvidal® for some niche populations, the on-the-ground practice reveals a more widespread use, including for unrecovered patients, or patients treated with methadone.

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Keywords : Buvidal^®, Buprenorphine, France