Buprenorphine for the Treatment of Neonatal Abstinence Syndrome
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Purpose
Neonatal abstinence syndrome is a disease that affects children who were exposed to opioid drugs prior to birth. Commonly used treatments at present include morphine or tincture of opium. Buprenorphine is a drug used in adults to treat narcotic dependence, but has not been used for Neonatal Abstinence Syndrome. This trial is designed to see if the use of sublingual (under the tongue) buprenorphine is able to be used safely and easily in newborns with the neonatal abstinence syndrome. Secondary goals will be to see if treatment with buprenorphine is associated shorter stays in the hospital and fewer days of treatment than the use of standard therapy. Another secondary goal will be to understand buprenorphine concentration in the blood of babies treated with the drug (this is called "pharmacokinetics").
| Condition | Intervention | Phase |
|---|---|---|
|
Neonatal Abstinence Syndrome |
Drug: buprenorphine Drug: Oral morphine solution |
Phase 1 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Buprenorphine for the Treatment of Neonatal Abstinence Syndrome |
- Sublingual Buprenorphine safety and tolerability in the neonate [ Time Frame: Index hospitalization ] [ Designated as safety issue: Yes ]
- Buprenorphine Pharmacokinetics [ Time Frame: Index hospitalization ] [ Designated as safety issue: No ]
- Efficacy: Length of treatment [ Time Frame: Index hospitalization ] [ Designated as safety issue: No ]
- Efficacy: Length of hospitalization [ Time Frame: Index hospitalization ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 60 |
| Study Start Date: | April 2004 |
| Study Completion Date: | January 2010 |
| Primary Completion Date: | January 2010 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: Oral morphine solution
Oral morphine solution
|
Drug: Oral morphine solution
0.4 mg/kg/day morphine every 4 hours
Other Name: morphine
|
|
Experimental: Buprenorphine
Sublingual buprenorphine
|
Drug: buprenorphine
sublingual buprenorphine administered every 8 hours, titrated to control of abstinence symptoms
Other Name: Buprenex (buprenorphine)
|
Eligibility| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- ≥ 37 weeks gestation
- exposure to opiates in utero
- demonstration of signs and symptoms of neonatal abstinence syndrome requiring treatment
Exclusion Criteria:
- major congenital malformations and/or intrauterine growth retardation
- medical illness requiring intensification of medical therapy
- concomitant benzodiazepine or severe alcohol abuse, self-report of regular use of alcohol or of benzodiazepines use in the past 30 days, and/or receipt of benzodiazepines by prescription (as determined by self-report or intake urine) by the mother during pregnancy,
- concomitant use of CYP 3A inhibitors (erythromycin, clarithromycin, ketoconazole, itraconazole, HIV protease inhibitors) or inducers (rifampin, carbamazepine, phenobarbital) prior to initiation of NAS treatment
- seizure activity or other neurologic abnormality
- breast feeding
- inability of mother to give informed consent due to co-morbid psychiatric diagnosis
- hypoglycemia requiring treatment with intravenous glucose
Contacts and Locations| United States, Pennsylvania | |
| Thomas Jefferson University Hospital | |
| Philadelphia, Pennsylvania, United States, 19107 | |
| Principal Investigator: | Walter K Kraft, MD, MS | Thomas Jefferson University |
More Information
Publications:
| Responsible Party: | Steve Oversby, NIDA |
| ClinicalTrials.gov Identifier: | NCT00521248 History of Changes |
| Other Study ID Numbers: | R21 DA018207-01, R21DA018207-01, DPMC |
| Study First Received: | August 23, 2007 |
| Last Updated: | October 20, 2011 |
| Health Authority: | United States: Food and Drug Administration |
Keywords provided by National Institute on Drug Abuse (NIDA):
|
Neonatal Abstinence Syndrome buprenorphine neonatal opioid withdrawal |
Additional relevant MeSH terms:
|
Neonatal Abstinence Syndrome Infant, Newborn, Diseases Substance-Related Disorders Mental Disorders Buprenorphine Morphine Analgesics, Opioid Analgesics Sensory System Agents |
Peripheral Nervous System Agents Physiological Effects of Drugs Pharmacologic Actions Central Nervous System Agents Therapeutic Uses Central Nervous System Depressants Narcotic Antagonists Narcotics |
ClinicalTrials.gov processed this record on May 19, 2013