Community Studies of Long Acting Buprenorphine (CoLAB)

NCT ID: NCT03809143

Last Updated: 2020-03-05

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

UNKNOWN

Clinical Phase

PHASE3

Total Enrollment

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-05-22

Study Completion Date

2021-03-30

Brief Summary

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Despite research demonstrating the efficacy of buprenorphine (BPN), effectiveness in real-world settings has been limited by shorter retention than for methadone, and the need for daily or near-daily dosing (frequently supervised in Australia). Newly developed sustained-release BPN formulations could provide rapid onset and sustained release of BPN.

Current formulations include six-monthly implants, and once-weekly or once-monthly injections, removing the need for frequent clinic or pharmacy attendance. Improved medication adherence may result in improved patient outcomes and fewer unintended consequences such as diversion, but more data are needed in real-world settings. These innovations have the potential to dramatically change the treatment settings and options for people who are opioid dependent.

The study aims to evaluate the patient outcomes following the implementation of a monthly BPN depot injection for the treatment of opioid dependence in community-based treatment settings with a focus on opioid and other illicit drug use, adherence and retention, and participants' experiences of the implementation.

Detailed Description

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Opioid agonist treatment (OAT) is effective for opioid dependence and newer extended-release buprenorphine (BUP-XR) injections represent a significant development. The Community Long-Acting Buprenorphine (CoLAB) study aims to evaluate client outcomes among people with opioid dependence receiving 48 weeks of BUP-XR treatment, and examines the implementation of BUP-XR in diverse community healthcare settings in Australia.

The CoLAB study is a prospective single-arm, multicentre, open-label trial of monthly BUP-XR injections in people with opioid dependence. Participants are being recruited from a network of general practitioner and specialist drug treatment services located in the states of New South Wales, Victoria and South Australia in Australia. Following a minimum 7 days on 8-32mg of sublingual buprenorphine (+/- naloxone), participants will receive monthly subcutaneous BUP-XR injections administered by a healthcare practitioner at intervals of 28 days (-2/+14 days). The primary endpoint is participant retention in treatment at 48 weeks after treatment initiation. Secondary endpoints will evaluate dosing schedule variations, craving, withdrawal, substance use, health and well-being, and client-reported treatment experience. Qualitative and costing sub-studies will examine implementation barriers and facilitators at the client and provider level.

Conditions

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Opioid Dependence

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

NONE

Study Groups

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Depot buprenorphine arm

All participants will receive monthly injections of depot buprenorphine (RBP-6000, Sublocade)

Group Type EXPERIMENTAL

RBP-6000

Intervention Type DRUG

All study participants are scheduled to receive monthly subcutaneous injections of depot BPN, RBP-6000. RBP-6000 (BPN in the ATRIGEL® Delivery System) contains buprenorphine (200mg/mL) in the ATRIGEL® Delivery System, which provides sustained plasma level of BPN over a minimum of 28 days.

Interventions

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RBP-6000

All study participants are scheduled to receive monthly subcutaneous injections of depot BPN, RBP-6000. RBP-6000 (BPN in the ATRIGEL® Delivery System) contains buprenorphine (200mg/mL) in the ATRIGEL® Delivery System, which provides sustained plasma level of BPN over a minimum of 28 days.

Intervention Type DRUG

Other Intervention Names

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Sublocade

Eligibility Criteria

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Inclusion Criteria

1. Voluntarily signed the informed consent form
2. Aged 18 to 65 years
3. Opioid-dependent (ICD-10) currently receiving treatment
4. Has been receiving 8-32mg sublingual buprenorphine +/- naloxone tablets/film for at least 7 days
5. Negative pregnancy test at screening and baseline in females of childbearing potential (please refer to Section 5.7 for long acting reversible contraceptive methods with efficacy considered to reasonably eliminate pregnancy potential)

Exclusion Criteria

1. Currently lactating or pregnant, or of childbearing potential and not willing to avoid becoming pregnant during the study
2. History or presence of allergic or adverse response (including rash or anaphylaxis) to buprenorphine or the ATRIGEL® Delivery System
3. Significant, medical or psychiatric conditions (other than opioid dependence), or other circumstances which, in the opinion of the Investigator, would compromise compliance with the protocol and/or patient safety. Specific conditions of interest include severe hepatic disease (Child-Pugh Class B), severe renal or respiratory disease, or severe cognitive impairment or psychiatric condition that impairs the ability to provide informed consent (e.g. psychosis, delirium, hypomania, severe depression or suicidal ideation)
4. Subjects who are currently participating in any other clinical study involving investigational medication(s)
5. Inability or unwillingness to provide informed consent or abide by the requirements of the study
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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The University of New South Wales

OTHER

Sponsor Role lead

Responsible Party

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Marianne Byrne

Clinical Trials Manager, National Drug and Alcohol Research Centre

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Michael Farrell

Role: PRINCIPAL_INVESTIGATOR

National Drug and Alcohol Centre, University of New South Wales

Locations

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Drug and Alcohol Services, Hunter New England Local Health District

Newcastle, New South Wales, Australia

Site Status

Drug and Alcohol Services, North Sydney Local Health District

Saint Leonards, New South Wales, Australia

Site Status

Drug and Alcohol Services, South Australia (DASSA)

Morphett Vale, South Australia, Australia

Site Status

Western Health Drug Services, Footscray Hospital

Footscray, Victoria, Australia

Site Status

Frankston Healthcare

Frankston, Victoria, Australia

Site Status

Rankin Court Treatment Centre, St Vincent's Hospital Sydney

Darlinghurst, , Australia

Site Status

Countries

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Australia

References

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Farrell M, Shahbazi J, Byrne M, Grebely J, Lintzeris N, Chambers M, Larance B, Ali R, Nielsen S, Dunlop A, Dore GJ, McDonough M, Montebello M, Nicholas T, Weiss R, Rodgers C, Cook J, Degenhardt L; CoLAB study team. Outcomes of a single-arm implementation trial of extended-release subcutaneous buprenorphine depot injections in people with opioid dependence. Int J Drug Policy. 2022 Feb;100:103492. doi: 10.1016/j.drugpo.2021.103492. Epub 2021 Nov 1.

Reference Type DERIVED
PMID: 34736130 (View on PubMed)

Larance B, Byrne M, Lintzeris N, Nielsen S, Grebely J, Degenhardt L, Shahbazi J, Shanahan M, Lancaster K, Dore G, Ali R, Farrell M; CoLAB study team. Open-label, multicentre, single-arm trial of monthly injections of depot buprenorphine in people with opioid dependence: protocol for the CoLAB study. BMJ Open. 2020 Jul 31;10(7):e034389. doi: 10.1136/bmjopen-2019-034389.

Reference Type DERIVED
PMID: 32737087 (View on PubMed)

Other Identifiers

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CoLAB1801

Identifier Type: -

Identifier Source: org_study_id

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