2026-10-12T07:30:32Z https://api.figshare.com/v2/oai

oai:figshare.com:article/33340427 2026-09-29T15:38:49Z category_19 category_21 category_39 category_64 category_106 category_132 portal_87 item_type_3 month_year_09_2026

Extended-release naltrexone versus buprenorphine-naloxone for opioid use disorder: a systematic review and meta-analysis of randomized controlled trials Alper Mert (24653976) Duhan Kılıçkan (24654680) Maria Luiza Rodrigues Defante (20468225) Samuel Izaias dos Santos Pereira (25137700) Otavio André Farias Sousa da Silva (24654686) Jussi Jokinen (569241) Pharmacology Biotechnology Ecology Cancer Science Policy Infectious Diseases Opioid use disorder Extended-release naltrexone Buprenorphine-naloxone addiction Meta-analysis <p><i>Background:</i> Extended-release naltrexone (XR-NTX) and buprenorphine-naloxone (BUP-NLX) are approved for opioid use disorder (OUD), but their comparative efficacy and safety are unclear.</p> <p><i>Objectives:</i> We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing XR-NTX and BUP-NLX.</p> <p><i>Methods:</i> PubMed, Embase, and Cochrane were searched from inception to July 2025. Main efficacy outcomes were treatment initiation, retention, time to relapse, number of relapses, opioid-positive urine samples, and self-reported opioid use days. Odds ratios (OR), mean differences (MD), and hazard ratios (HR) with 95% confidence intervals (CI) were calculated. Heterogeneity was assessed with I² and evidence certainty rated with GRADE.</p> <p><i>Results:</i> Five RCTs comprising 1,043 patients (68.2% male; XR-NTX, <i>n</i> = 512; BUP-NLX, <i>n</i> = 531) were included. Treatment initiation was lower with XR-NTX (OR 0.27; 95% CI 0.12–0.64; <i>p</i> = .003; I² = 67.6%). There were no differences in treatment retention (OR 0.85; 95% CI 0.65–1.11; <i>p</i> = .25; I² = 0%). XR-NTX was associated with a significantly lower proportion of opioid-positive urine samples (OR 0.52; 95% CI 0.38–0.73; <i>p</i> < .001; I² = 0%). There were no differences in relapse (OR 0.60; 95% CI 0.21–1.73; <i>p</i> = .35; I² = 89.9%), opioid use days in 30 days (MD − 0.99; 95% CI − 3.62 to 1.64; <i>p</i> = .46; I² = 63.8%), or adverse events.</p> <p><i>Conclusion:</i> XR-NTX and BUP-NLX did not differ across most outcomes, though initiation was lower with XR-NTX and evidence certainty was very low to moderate. With neither clearly superior, initiating either treatment may matter most.</p> 2026-09-29T15:38:49Z Dataset Dataset 10.6084/m9.figshare.33340427.v2 https://figshare.com/articles/dataset/Extended-release_naltrexone_versus_buprenorphine-naloxone_for_opioid_use_disorder_a_systematic_review_and_meta-analysis_of_randomized_controlled_trials/33340427 CC BY 4.0