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buprenorphine

✓ Approved

Roche · OPRK1 · 小分子

什么是 buprenorphine？

buprenorphine 是一种小分子，由Roche研发。该药已获批，用于治疗相关适应症，给药途径：Oral (PO)、Sublingual (SL)/Oral Transmucosal。

药物档案

公司Roche
药物类别小分子
分子靶点OPRK1, OPRM1
给药途径Oral (PO), Sublingual (SL)/Oral Transmucosal
状态Approved
来源： ClinicalTrials.gov, Roche

作用机制

分子靶点

buprenorphine 作用于 2 个分子靶点：

OPRK1opioid receptor kappa 1 (KOR1, OPRK)
OPRM1opioid receptor mu 1 (MOR1, LMOR)
需要更深入的分析？Noah AI 可解释复杂机制并与同类药物比较。

治疗适应症

buprenorphine 针对 1 个适应症，涉及 1 个治疗领域。

治疗领域疾病/病症分期
Gastrointestinal disordersAbdominal pain✓ Approved

相关研究文献

PubMedCanadian family physician Medecin de famille canadien2026-06-13

Impact of virtual case conferences between primary care clinicians and an interdisciplinary chronic pain clinic.

Jorgenson Derek J DJ, Halpape Katelyn K, Marwah Radhika R, Siton Michael M

To assess the impact of virtual case conferences on referring primary care clinician knowledge, prescribing, and patient care practices. Paper-based postal survey. The USask Chronic Pain Clinic (UCPC) in Saskatoon, Sask. All referring health professionals who participated in a USask Chronic Pain Clinic case conference between July 2023 and December 2024 were included. Participants included family physicians (87.3%, n=48 of 55) and nurse practitioners (12.7%, n=7 of 55). The questionnaire collected data regarding participant demographic characteristics and various aspects of participants' chronic pain management knowledge, prescribing, and chronic pain care practices. A total of 168 questionnaires were mailed and the response rate was 32.7% (n=55 of 168). Most participants found case conferences to be a useful resource to their practices (94.5%) and reported that the service helped them with the management of their patients (92.7%). Many respondents reported improved knowledge about safe opioid prescribing (70.9%) and the process for opioid tapering (49.1%). Most agreed the knowledge they acquired from the case conference had been applied to additional patients in their practice (74.5%). Many respondents also felt more confident managing chronic pain (74.5%), more confident prescribing buprenorphine-naloxone for chronic pain (41.8%), and more willing to prescribe buprenorphine-naloxone for chronic pain (36.4%). Some had even prescribed buprenorphine-naloxone for chronic pain for the first time because of the case conference (30.9%). Case conferences between UCPC interdisciplinary chronic pain team members and referring primary care clinicians may be a valuable service to support referring providers in the care of their patients and to increase the capacity of the primary care system to manage chronic pain.

PMID 42285727
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PubMedAddiction (Abingdon, England)2026-06-13

A latent class analysis of clinical complexity: Secondary analysis of the collaboration leading to addiction treatment and recovery from other stresses (CLARO) randomized trial.

Schuler Megan S MS, Weir Rebecca R, McCullough Colleen M CM, Hindmarch Grace M GM et al.

Individuals with opioid use disorder (OUD) frequently present with co-occurring mental health conditions such as depression and posttraumatic stress disorder (PTSD), along with other mental health substance use disorders, physical health conditions and social determinants that together comprise 'clinical complexity.' Collaborative care (CC), a primary care-based behavioral health integration model, aims to improve outcomes through coordinated, patient-centered treatment. This study examined heterogeneity in baseline clinical complexity among participants in the CLARO (Collaboration Leading to Addiction Treatment and Recovery from Other Stresses) trial and assessed whether the effects of CC versus enhanced usual care (EUC) differed across clinical complexity groups. Secondary analysis of CLARO, a pragmatic randomized clinical trial (n = 797) of CC versus EUC for adults with OUD and depression and/or PTSD, conducted in 18 low-resourced primary care clinics in New Mexico and California, USA. Latent class analysis of baseline data identified subgroups defined by mental health and substance use as the main characteristics along with physical health and social challenges. Six-month treatment effects were estimated using one-step models that jointly estimated latent class membership and class-specific outcomes, incorporating class × treatment interactions. Outcomes included depression symptom severity, PTSD symptom severity, and buprenorphine utilization and prescribing duration. Three subgroups were identified: (1) low complexity (43%), with relative clinical and social stability; (2) mental health complexity (34%), with high psychiatric symptoms but lower substance use and moderate social adversity; and (3) high dual complexity (23%). Compared with EUC, CC was associated with lower depression severity at follow-up for the low-complexity class, but not for other classes. CC and EUC did not differ statistically significantly with respect to PTSD outcomes in any class. Buprenorphine utilization and prescribing duration outcomes were similar across CC and EUC treatment arms. The effects of collaborative care may vary according to patients' baseline clinical complexity. Collaborative care appears to be associated with more favorable depression outcomes than enhanced usual care among participants with lower clinical complexity but not among those with higher clinical complexity.

PMID 42286436
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PubMedThe journal of trauma and acute care surgery2026-06-12

Buprenorphine analgesia: Impacts on opioid burden and clinical trajectory in acute trauma care.

Conde-Yassin Sabri S, Gillen Jacob J, Stodghill Josh J, Collins Michael M et al.

Schedule II opioids are widely used for trauma analgesia but carry dose-dependent risks of respiratory depression, tolerance, hyperalgesia, and addiction. Buprenorphine, a Schedule III opioid, is a potent analgesic with a more favorable safety profile; however, its integration into trauma care remains uncharacterized. A single-center observational study included adult trauma patients admitted to a Level I trauma center from January 2021 to June 2024. The trauma service formalized buprenorphine analgesia in June 2023. Outcomes were assessed by (1) an unadjusted pre/post June 2023 analysis (pre-BΔ vs. post-BΔ) and (2) a 1:1 nearest-neighbor propensity score-matched comparison of post-BΔ patients who received (Bup+) or did not receive (Bup-) buprenorphine. Bup+ and Bup- groups were matched by demographics and injury characteristics. Sublingual/buccal and parenteral buprenorphine were assigned morphine milligram equivalents (MME) conversion factors of 30 and 100, respectively. Incidence rate ratios (IRRs) with 95% CI were calculated; significance was set at p <0.05. Unadjusted analysis included 3,935 patients (2,777 pre-BΔ; 1,158 post-BΔ). Increased buprenorphine use was associated with reduced MME (median, 138 pre-BΔ vs. 75 post-BΔ; p < 0.001; IRR, 0.70; 95% CI, 0.69-0.71), lower intensive care unit (ICU) admission rates (IRR, 0.78; 95% CI, 0.73-0.83), and shortened ICU length of stay (IRR, 0.87; 95% CI, 0.80-0.94). In the matched post-BΔ cohort (n = 544) buprenorphine use was associated with lower ICU admission (IRR, 0.63; 95% CI, 0.54-0.73) and shorter ICU length of stay (IRR, 0.67; 95% CI, 0.59-0.75); median MME did not differ (114 vs. 91, p = 0.187), though IRR analyses demonstrated lower opioid exposure (IRR, 0.82; 95% CI, 0.81-0.83). Across analyses, no differences were observed in survival or adverse events. In trauma patients, Schedule III buprenorphine analgesia was associated with reduced inpatient opioid exposure and ICU escalation. Further validation may establish buprenorphine as an advance in opioid stewardship for vulnerable trauma populations. (J Trauma Acute Care Surg 2026;00:000-000. Copyright © 2026 Wolters Kluwer Health, Inc. All rights reserved.). Therapeutic/Care Management; Level III.

PMID 42283437
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PubMedAddiction (Abingdon, England)2026-06-12

The association between naloxone distribution, buprenorphine treatment and retention and incident high-risk opioid prescribing with opioid overdose death in Kentucky, Massachusetts, New York and Ohio, United States: An exploratory community-level cohort study of data from the HEALing Communities Study.

Walley Alexander Y AY, Cheng Debbie M DM, Vandergrift Nathan N, Larochelle Marc M et al.

We evaluated whether community-level naloxone distribution, medication for opioid use disorder treatment and retention and incident high-risk opioid prescribing rates were associated with opioid overdose death rates. Observational cohort conducted using 2019 to 2023 community-level data as an exploratory analysis of the HEALing (Helping to End Addiction Long-term®) Communities Study (HCS). Exposures included: (1) community-level naloxone distribution, past 12-months, categorized as ≤1000 units per 100 000 population vs. 1001-3000 units per 100 000 population vs. >3000 units per 100 000 population; (2) individuals treated with buprenorphine per 100 000 adult population in the current quarter; (3) individuals retained on buprenorphine for ≥ 180 days per 100 000 adult population in the current quarter; and (4) incident high-risk opioid prescribing per 100 000 adult population in the current quarter. Population-based study of 67 communities with 8.2 million adults in Kentucky, Massachusetts, New York and Ohio, USA, with required annual opioid overdose death rates of > 25 per 100 000 adult population and at least 30% rural. Across the 67 communities participating in the HCS, the adult population was 31% 18-34 years, 31% 35-54 years, 38% 55 years and over, 52% female, 73% non-Hispanic White, 15% non-Hispanic Black and 7.4% Hispanic. Quarterly community-level opioid overdose death rates from 2020 through 2023. The 2019 annual rates were 40.4 opioid overdose deaths, 1287 naloxone rescue units distributed, 977.7 people received buprenorphine treatment, 546.3 people retained for more than 180 days on buprenorphine and 1266.7 high-risk opioid prescribing incidents per 100 000 population. In models adjusted for state, community age, sex, race/ethnicity, rurality, HCS intervention group assignment, 2019 rates of opioid overdose death, naloxone distribution, buprenorphine and high-risk opioid prescribing, and the ratio of opioid overdose deaths involving fentanyl, an increase in 100 people treated with buprenorphine per 100 000 population was associated with a decrease of 0.92 [95% confidence interval (CI) = -1.30 to -0.55] in the quarterly opioid overdose death rate, while an increase of 100 people retained on buprenorphine for more than 180 days per 100 000 population was associated with a decrease of 1.3 (95% CI = -1.8 to -0. 76). There were no statistically significant associations between naloxone distribution or incident high-risk opioid prescribing with change in quarterly opioid overdose death rates. In this exploratory analysis, increases in both buprenorphine treatment and retention were statistically significantly associated with decreases in opioid overdose death rates, after adjusting for baseline rates of buprenorphine treatment and retention.

PMID 42283399
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PubMedAustralasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists2026-06-12

Telehealth-supported ketamine for depression and anxiety: A systematic review.

Mane Eden E, Mane Saras S

ObjectivesTo systematically review the effectiveness, safety, and care models of telehealth-supported ketamine for depression and/or anxiety in adults and consider implications for Australasian clinical practice.MethodsFollowing PRISMA 2020, we searched for randomised or observational studies of adults receiving at-home telehealth-supported ketamine for depression and/or anxiety, to August 2025. Primary outcomes were ≥50% symptom reduction and remission. Programme characteristics were synthesised narratively. Risk of bias and certainty of evidence were assessed. Protocol was not registered, and the study was not funded.ResultsOf 3,857 records screened, three met criteria, all from US commercial providers. Programmes differed in dosing schedules, clinical staffing, supervision, and safety monitoring. Across up to 16,876 patients, follow-up outcome data were available for a minority. Response ranged 49.5-62.8% (PHQ-9) and 47.6-62.9% (GAD-7), and remission 20.7-32.6% and 23.9-31.3%, respectively. All studies were at critical overall risk of bias. GRADE certainty for effectiveness and safety was very low.ConclusionsTelehealth-supported sublingual racemic ketamine was associated with symptom improvements in selected populations. Yet, the evidence base is provider generated, and at critical risk of bias. Its main contribution to Australasia is to inform consideration of model components for a future hybrid service design.

PMID 42277616
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PubMedJournal of addiction medicine2026-06-12

An Equitable Behavioral Engagement Framework for Stimulant Medication Treatment in Methamphetamine Use Disorder.

Kelly Deirdra D, Lites Ann A, Campbell Arianna A, Bottyan Thomas T

The 2024 American Society of Addiction Medicine and American Academy of Addiction Psychiatry Clinical Practice Guideline includes a conditional recommendation for long-acting methylphenidate as a pharmacologic option for amphetamine-type stimulant use disorder, including methamphetamine use disorder. Although this recommendation is conditional and based on low-certainty evidence, it reflects an evolving consideration of pharmacologic treatment approaches for methamphetamine use disorder and raises questions regarding clinical implementation, particularly given the schedule II regulatory status of methylphenidate and the associated oversight and risk considerations. In this commentary, we review the guideline's recommendation in the context of real-world prescribing challenges, including clinical safety considerations, monitoring requirements, and potential implications for equitable access. We highlight the absence of established behavioral readiness or engagement frameworks to guide the initiation and continuation of schedule II stimulant medications for methamphetamine use disorder. To address this gap, we describe an approach adapted from prior work in office-based buprenorphine treatment. This 5-domain framework-adherence, abstinence progress, attendance, alternative activities, and accessing support-offers a structured method for integrating behavioral engagement into patient selection and ongoing monitoring when considering prescribing a psychostimulant for stimulant use disorders. By emphasizing objective, transparent engagement metrics alongside pharmacologic decision-making, such a framework may help support safety, accountability, and a more equitable application of an emerging treatment option.

PMID 42283199
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