Journal of Addiction Medicine 2010;4(4):211-216. [doi: 10.1097/ADM.0b013e3181c4e27e]
Michael P. Bogenschutz, MD (Center on Alcoholism, Substance Abuse, and Addictions (CASAA), SW Node), Patrick Abbott, MD (Addiction and Substance Abuse Programs (ASAP), SW Node), Robert Kushner, MD (Center on Alcoholism, Substance Abuse, and Addictions, SW Node), J. Scott Tonigan, PhD (Center on Alcoholism, Substance Abuse, and Addictions, SW Node), George E. Woody, MD (University of Pennsylvania School of Medicine, DV Node).
The purpose of this study was to explore changes in transaminase values associated with buprenorphine treatment and hepatitis C status among opioid dependent subjects aged 15-21. One-hundred-and-fifty-two subjects seeking treatment for opioid dependence were randomized to 2-week detoxification with buprenorphine/naloxone (DETOX) or 12 weeks buprenorphine/naloxone (BUP). Liver chemistries including transaminases were obtained at baseline and 4, 8, and 12 weeks. One-hundred-and-eleven patients had at least one set of transaminases during treatment and were included in analyses of treatment effects. Overall, 8/60 BUP participants vs. 12/51 DETOX participants had at least one elevated ALT value during follow-up. Five BUP participants vs. eleven DETOX participants had at least one elevated ALT value. Twenty-eight out of 152 participants were hepatitis C (HCV) positive at baseline, and 4 seroconverted within 12 weeks, 2 in each group. HCV status was significantly associated with transaminase abnormalities (p=.009 and p=.006 for ALT and AST, respectively). HCV status had a strong effect on transaminase abnormalities among participants assigned to DETOX, but not among those assigned to BUP. No evidence was found for hepatotoxicity of buprenorphine in this exploratory analysis. HCV was present in a significant minority of participants and was a significant predictor of transaminase elevation. Results suggest that stabilization on buprenorphine may decrease the frequency of transaminase abnormalities associated with HCV in opioid dependent young people. The high rate of seroconversion underscores the importance of effective treatment and prevention. (Article (Peer-Reviewed), PDF, English, 2010)
Keywords: Adolescents | Buprenorphine | Buprenorphine/Naloxone | CTN platform/ancillary study | Hepatitis C | Liver enzyles | Opioid dependence | Opioid detoxification | Pharmacological therapy | Suboxone | Young adults | Journal of Addiction Medicine (journal)
Document No: 400, PMID: 21170166, PMCID: PMC3002235.
Submitted by Jack Blaine, MD, CCTN, 10/7/2009.