XRB vs. SLB in Jail and at Re-entry: Pilot, Proof of Concept
Buprenorphine Extended-release in Jail and at Re-entry: Open-label Randomized Controlled Trial vs. Daily Sublingual Buprenorphine-naloxone
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Study Locations
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New York
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New York, New York, United States, 10016
- Bellevue Hospital Center
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Adults >18yo incarcerated in NYC jails with known release dates.
- DSM-V criteria for current opioid use disorder (DSM-IV opioid dependence).
- Currently maintained on sublingual buprenorphine-naloxone in the NYC jail opioid treatment program.
Exclusion Criteria:
- Individual not interested in XRB treatment. Current SLB patients are otherwise by definition appropriate for XRB.
- Pregnant or planning conception. A urine dipstick pregnancy (hCG) test will be administered at baseline. The test detects human chorionic gonadotropin (hCG) in urine with a sensitivity/specificity of: 25 mIU hCG/ml, >99%. Time to result is four minutes. If negative, a urine pregnancy test will be administered bi-weekly thereafter to ensure that a participant is not pregnant
- No severe or acute medical or psychiatric disability preventing safe study participation or making follow-up unlikely.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: NONE
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
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EXPERIMENTAL: Buprenorphine Extended-Release
XRB is a 300mg pre-mixed subcutaneous injectable formulation to be administered monthly.
XRB is for abdominal subcutaneous injection only.
Participants in the XRB treatment arm will be given 1 or more XRB injections prior to release from jail and one more at week 5 post-release, depending on their release date.
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XRB is available in dosage strengths of 100 mg/0.5 mL and 300 mg/1.5 mL buprenorphine.
Each dose is provided in a prefilled syringe with a 19 gauge 5/8-inch needle.
Other Names:
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ACTIVE_COMPARATOR: Sublingual Buprenorphine
SLB (SUBOXONE, Zubsolv, or generic tablets) is a daily sublingual film or tablet ranging from 8-24mg/day or equivalent (Zubsolv is dosed 5.7-17.1 mg/day).
The film or tablet is placed under the tongue for 5 to 10 minutes until dissolved completely.
Participants in the SLB treatment arm will be provided SLB daily by observed dosing in-jail (controlled substances are not self-administered in-jail) and and encouraged to continue SLB treatment in weekly, bi-weekly, or monthly quantities for unobserved, daily, self-administration through week 5. Patients may also elect to obtain SLB care free-of-charge from the Bellevue Hospital Center Addiction Medicine clinic or from non-NYU/Bellevue providers and pharmacies per usual care standards.
SLB will not be provided via the study.
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SLB is administered sublingually or buccally as a single daily dose.
Medication should be prescribed in consideration of the frequency of visits.
Provision of multiple refills is not advised in early treatment or without appropriate follow-up visits.
After treatment induction and stabilization, the maintenance dose of SLB is generally in the range of 4mg/1mg buprenorphine/naloxone to 24mg/6mg buprenorphine/naloxone per day depending on the individual patient and clinical response.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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# of Participants Retained on Any Form of Community Buprenorphine (Not Randomzied tx) at Week 8
Time Frame: 8 Weeks
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Retained on any form of community buprenorphine treatment at Week 8
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8 Weeks
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# of Participants Retained on Their Randomly Assigned Treatment at Week 8
Time Frame: 8 weeks
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Retained on assigned treatment at Week 8
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8 weeks
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Mean # of Weeks (0-8) on Any Buprenorphine Treatment
Time Frame: 8 weeks
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Weeks (0-8) on buprenorphine treatment, mean (SD)
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8 weeks
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Urine Samples Opioid-negative
Time Frame: 8 weeks
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number of opioid-negative urine samples
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8 weeks
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the # of Participants Re-incarcerated
Time Frame: 8 weeks
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Re-incarceration
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8 weeks
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The Mean In-jail Medical Visits Per Day Following Randomization and Induction on Study Medication
Time Frame: Post-randomization and pre-release, (0-3 months)
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Jail medical clinic visits per day following study medication induciton, mean
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Post-randomization and pre-release, (0-3 months)
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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The # of Participants That Received Their Randomly Assigned Study Medication
Time Frame: 8 Weeks
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Received assigned study medication
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8 Weeks
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The # of Participants Who Received Their Randomly Assigned Study Medication Prior to Release From Jail as Scheduled
Time Frame: 0-3 months (pre-release)
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Received assigned study medication prior to release as scheduled
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0-3 months (pre-release)
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Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Joshua D Lee, MD, MSc, NYU School of Medicine
Publications and helpful links
General Publications
- Cheng A, Badolato R, Segoshi A, McDonald R, Malone M, Vasudevan K, Badiei B, Sugarman A, Macdonald R, Mangat J, Giftos J, Lee JD, Tofighi B. Perceptions and experiences toward extended-release buprenorphine among persons leaving jail with opioid use disorders before and during COVID-19: an in-depth qualitative study. Addict Sci Clin Pract. 2022 Jan 29;17(1):4. doi: 10.1186/s13722-022-00288-4.
- Lee JD, Malone M, McDonald R, Cheng A, Vasudevan K, Tofighi B, Garment A, Porter B, Goldfeld KS, Matteo M, Mangat J, Katyal M, Giftos J, MacDonald R. Comparison of Treatment Retention of Adults With Opioid Addiction Managed With Extended-Release Buprenorphine vs Daily Sublingual Buprenorphine-Naloxone at Time of Release From Jail. JAMA Netw Open. 2021 Sep 1;4(9):e2123032. doi: 10.1001/jamanetworkopen.2021.23032.
Study record dates
Study Major Dates
Study Start (ACTUAL)
Study Start
Primary Completion (ACTUAL)
Primary Completion
Study Completion (ACTUAL)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (ACTUAL)
First Posted
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Mental Disorders
- Chemically-Induced Disorders
- Substance-Related Disorders
- Narcotic-Related Disorders
- Opioid-Related Disorders
- Physiological Effects of Drugs
- Central Nervous System Depressants
- Peripheral Nervous System Agents
- Analgesics
- Sensory System Agents
- Analgesics, Opioid
- Narcotics
- Narcotic Antagonists
- Buprenorphine
- Buprenorphine, Naloxone Drug Combination
Other Study ID Numbers
Other Study ID Numbers
- 18-00823
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- ICF
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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