Naltrexone vs Buprenorphine-Naloxone for Opioid Dependence in Norway

NCT ID: NCT01717963

Last Updated: 2018-10-11

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

166 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-10-31

Study Completion Date

2018-04-30

Brief Summary

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Persons dependent on opioids like heroin, morphine, or codeine have a high risk of relapse, overdose and overdose death. This risk is elevated even further following discharge from treatment or correctional institutions where patients have been detoxified. At the moment, state-of-the-art treatment is based on maintaining the dependence on opioids by daily intake of opioid medications like methadone or buprenorphine. Recently, a medication containing the blocking agent naltrexone was approved in the US; this does not maintain dependence but instead blocks heroin and other opioids for 28 days after intramuscular administration. This study will conduct a 12-week randomized comparison of naltrexone intramuscular suspension (XL-NTX) with daily buprenorphine-naloxone in OMT. Medication will start preceding discharge from a treatment or correctional facility to participating catchment regions in Norway. The main hypotheses are that XL-NTX will do equally well as - or better than - OMT on the proportion of biological samples negative for opioids, retention, self-reported use of alcohol and illicit drugs. Following the 12-week randomized period, there will be a 36-week period where participants can receive the study medication of their choice. After the end of the study, data from national registry databases can be collected for a further 12 months on outcomes such as recidivism, mortality and morbidity.

Detailed Description

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Conditions

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Opioid Dependence

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Naltrexone intramuscular suspension

Extended release naltrexone injections 380mg

Group Type EXPERIMENTAL

Naltrexone intramuscular suspension

Intervention Type DRUG

A standard dosage of 380 mg / month of naltrexone intramuscular suspension will be administered

Buprenorphine-naloxone

Flexible oral dose 4-24 mg daily

Group Type ACTIVE_COMPARATOR

Buprenorphine-naloxone

Intervention Type DRUG

Buprenorphine-naloxone is administered daily and provided in accordance with existing guidelines for OMT in Norway (treatment-as-usual).

Interventions

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Naltrexone intramuscular suspension

A standard dosage of 380 mg / month of naltrexone intramuscular suspension will be administered

Intervention Type DRUG

Buprenorphine-naloxone

Buprenorphine-naloxone is administered daily and provided in accordance with existing guidelines for OMT in Norway (treatment-as-usual).

Intervention Type DRUG

Other Intervention Names

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Long-acting naltrexone Extended-release naltrexone XR-NTX Vivitrol Suboxone

Eligibility Criteria

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Inclusion Criteria

* Opioid dependence (DSM-IV TR)
* Age 18 or above
* Applied \& Approved for Norway's national OMT program
* Discharge within 30 days of inclusion from a controlled environment; e.g. inpatient treatment or correctional (prison) facility
* Voluntarily seeking treatment for opioid dependence

Exclusion Criteria

* Pregnant or breast-feeding
* Acute or recurring severe psychiatric disorder, e.g. psychosis, suicidality
* Serious debilitation of liver or renal function (e.g. Child-Pugh level C)
* Use of excluded medication
* Known intolerance to study drugs or their ingredients
* Employment in firm manufacturing one of the study drugs or close relation to such person
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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The Research Council of Norway

OTHER

Sponsor Role collaborator

The Royal Norwegian Ministry of Health

OTHER

Sponsor Role collaborator

Norwegian Institute of Public Health

OTHER_GOV

Sponsor Role collaborator

Oslo University Hospital

OTHER

Sponsor Role collaborator

University Hospital, Akershus

OTHER

Sponsor Role collaborator

Haukeland University Hospital

OTHER

Sponsor Role collaborator

Helse Stavanger HF

OTHER_GOV

Sponsor Role collaborator

The Hospital of Vestfold

OTHER

Sponsor Role collaborator

Ostfold Hospital Trust

OTHER

Sponsor Role collaborator

University of Oslo

OTHER

Sponsor Role lead

Responsible Party

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Lars Tanum

National Coordinating Investigator (PI)

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Lars Tanum, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Oslo

Locations

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Akershus University Hospital

Oslo, Akershus, Norway

Site Status

Haukeland University Hospital

Bergen, Hordaland, Norway

Site Status

Stavanger University Hospital

Stavanger, Rogaland, Norway

Site Status

Vestfold Hospital Trust

Tønsberg, Vestfold, Norway

Site Status

Oslo University Hospital, Avdeling for Rus og Avhengighet

Oslo, , Norway

Site Status

Countries

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Norway

References

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Kornor H, Lobmaier PPK, Kunoe N. Sustained-release naltrexone for opioid dependence. Cochrane Database Syst Rev. 2025 May 9;5(5):CD006140. doi: 10.1002/14651858.CD006140.pub3.

Reference Type DERIVED
PMID: 40342086 (View on PubMed)

Solli KK, Benth JS, Digranes LCW, Holtan L, Kunoe N, Tanum L. Changes in mental health during long-term treatment with extended-release naltrexone: A 3-year clinical study of opioid dependent individuals. Contemp Clin Trials. 2025 May;152:107861. doi: 10.1016/j.cct.2025.107861. Epub 2025 Feb 21.

Reference Type DERIVED
PMID: 39987958 (View on PubMed)

Opheim A, Benth JS, Solli KK, Kloster PS, Fadnes LT, Kunoe N, Gaulen Z, Tanum L. Risk of relapse to non-opioid addictive substances among opioid dependent patients treated with an opioid receptor antagonist or a partial agonist: A randomized clinical trial. Contemp Clin Trials. 2023 Dec;135:107360. doi: 10.1016/j.cct.2023.107360. Epub 2023 Oct 19.

Reference Type DERIVED
PMID: 37865138 (View on PubMed)

Opheim A, Gaulen Z, Solli KK, Latif ZE, Fadnes LT, Benth JS, Kunoe N, Tanum L. Risk of Relapse Among Opioid-Dependent Patients Treated With Extended-Release Naltrexone or Buprenorphine-Naloxone: A Randomized Clinical Trial. Am J Addict. 2021 Sep;30(5):453-460. doi: 10.1111/ajad.13151.

Reference Type DERIVED
PMID: 34487395 (View on PubMed)

Latif ZE, Solli KK, Opheim A, Kunoe N, Benth JS, Krajci P, Sharma-Haase K, Tanum L. No increased pain among opioid-dependent individuals treated with extended-release naltrexone or buprenorphine-naloxone: A 3-month randomized study and 9-month open-treatment follow-up study. Am J Addict. 2019 Feb;28(2):77-85. doi: 10.1111/ajad.12859. Epub 2019 Jan 31.

Reference Type DERIVED
PMID: 30701613 (View on PubMed)

Latif ZE, Saltyte Benth J, Solli KK, Opheim A, Kunoe N, Krajci P, Sharma-Haase K, Tanum L. Anxiety, Depression, and Insomnia Among Adults With Opioid Dependence Treated With Extended-Release Naltrexone vs Buprenorphine-Naloxone: A Randomized Clinical Trial and Follow-up Study. JAMA Psychiatry. 2019 Feb 1;76(2):127-134. doi: 10.1001/jamapsychiatry.2018.3537.

Reference Type DERIVED
PMID: 30566177 (View on PubMed)

Solli KK, Latif ZE, Opheim A, Krajci P, Sharma-Haase K, Benth JS, Tanum L, Kunoe N. Effectiveness, safety and feasibility of extended-release naltrexone for opioid dependence: a 9-month follow-up to a 3-month randomized trial. Addiction. 2018 Oct;113(10):1840-1849. doi: 10.1111/add.14278. Epub 2018 Jun 22.

Reference Type DERIVED
PMID: 29806872 (View on PubMed)

Tanum L, Solli KK, Latif ZE, Benth JS, Opheim A, Sharma-Haase K, Krajci P, Kunoe N. Effectiveness of Injectable Extended-Release Naltrexone vs Daily Buprenorphine-Naloxone for Opioid Dependence: A Randomized Clinical Noninferiority Trial. JAMA Psychiatry. 2017 Dec 1;74(12):1197-1205. doi: 10.1001/jamapsychiatry.2017.3206.

Reference Type DERIVED
PMID: 29049469 (View on PubMed)

Kunoe N, Opheim A, Solli KK, Gaulen Z, Sharma-Haase K, Latif ZE, Tanum L. Design of a randomized controlled trial of extended-release naltrexone versus daily buprenorphine-naloxone for opioid dependence in Norway (NTX-SBX). BMC Pharmacol Toxicol. 2016 Apr 28;17(1):18. doi: 10.1186/s40360-016-0061-1.

Reference Type DERIVED
PMID: 27121539 (View on PubMed)

Related Links

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http://www.seraf.uio.no/

Webpage of the study Sponsor: The Norwegian Centre for Addiction Research, Univ of Oslo

Other Identifiers

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204725-1

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

2011-002858-31

Identifier Type: -

Identifier Source: org_study_id

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