Weekly extended‑release buprenorphine led to higher illicit‑opioid abstinence in pregnancy

A NIH‑supported randomized trial found weekly injectable extended‑release buprenorphine produced higher rates of abstinence from illicit opioids during pregnancy than daily sublingual buprenorphine, and serious maternal adverse events were less common; neonatal withdrawal outcomes were similar.

Researchers supported by the National Institutes of Health conducted a randomized, multicenter trial comparing weekly injectable extended‑release buprenorphine with daily sublingual buprenorphine for opioid use disorder during pregnancy. The trial enrolled 140 pregnant adults and was run within the NIDA Clinical Trials Network as part of the NIH HEAL Initiative. Results were published in JAMA Internal Medicine and are presented as evidence about medication options during pregnancy. The report notes differences in abstinence and serious adverse events between the two treatments. Key facts: - Study type and size: multicenter randomized trial with 140 pregnant adults comparing weekly injectable extended‑release buprenorphine to daily sublingual buprenorphine (with or without naloxone). - Main outcome during pregnancy: higher rates of illicit opioid abstinence by urine drug screen were observed in the extended‑release group. - Safety signals: serious maternal adverse events were reported less often in the extended‑release group; non‑serious events were similar overall but more often rated as medication‑related in the extended‑release group during pregnancy. - Neonatal outcome: rates of neonatal opioid withdrawal syndrome (NOWS) did not differ between treatment groups; postpartum outcomes were reported as non‑inferior. Summary: The trial found that weekly injectable extended‑release buprenorphine was associated with higher abstinence from illicit opioids in pregnancy and fewer serious maternal adverse events, while neonatal withdrawal outcomes were similar between groups. The findings were published in JAMA Internal Medicine and are described as supporting the use of this formulation in pregnancy. Undetermined at this time.