IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0266142.html
   My bibliography  Save this article

Relative effectiveness of medications for opioid-related disorders: A systematic review and network meta-analysis of randomized controlled trials

Author

Listed:
  • Jihoon Lim
  • Imen Farhat
  • Antonios Douros
  • Dimitra Panagiotoglou

Abstract

Introduction: Several pharmacotherapeutic interventions are available for maintenance treatment for opioid-related disorders. However, previous meta-analyses have been limited to pairwise comparisons of these interventions, and their efficacy relative to all others remains unclear. Our objective was to unify findings from different healthcare practices and generate evidence to strengthen clinical treatment protocols for the most widely prescribed medications for opioid-use disorders. Methods: We searched Medline, EMBASE, PsycINFO, CENTRAL, and ClinicalTrials.gov for all relevant randomized controlled trials (RCT) from database inception to February 12, 2022. Primary outcome was treatment retention, and secondary outcome was opioid use measured by urinalysis. We calculated risk ratios (RR) and 95% credible interval (CrI) using Bayesian network meta-analysis (NMA) for available evidence. We assessed the credibility of the NMA using the Confidence in Network Meta-Analysis tool. Results: Seventy-nine RCTs met the inclusion criteria. Due to heterogeneity in measuring opioid use and reporting format between studies, we conducted NMA only for treatment retention. Methadone was the highest ranked intervention (Surface Under the Cumulative Ranking [SUCRA] = 0.901) in the network with control being the lowest (SUCRA = 0.000). Methadone was superior to buprenorphine for treatment retention (RR = 1.22; 95% CrI = 1.06–1.40) and buprenorphine superior to naltrexone (RR = 1.39; 95% CrI = 1.10–1.80). However, due to a limited number of high-quality trials, confidence in the network estimates of other treatment pairs involving naltrexone and slow-release oral morphine (SROM) remains low. Conclusion: All treatments had higher retention than the non-pharmacotherapeutic control group. However, additional high-quality RCTs are needed to estimate more accurately the extent of efficacy of naltrexone and SROM relative to other medications. For pharmacotherapies with established efficacy profiles, assessment of their long-term comparative effectiveness may be warranted. Trial Registration: This systematic review has been registered with PROSPERO (https://www.crd.york.ac.uk/prospero) (identifier CRD42021256212).

Suggested Citation

  • Jihoon Lim & Imen Farhat & Antonios Douros & Dimitra Panagiotoglou, 2022. "Relative effectiveness of medications for opioid-related disorders: A systematic review and network meta-analysis of randomized controlled trials," PLOS ONE, Public Library of Science, vol. 17(3), pages 1-30, March.
    • Handle: RePEc:plo:pone00:0266142
    DOI: 10.1371/journal.pone.0266142
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0266142
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0266142&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0266142?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Yancovitz, S.R. & Des Jarlais, D.C. & Peyser, N.P. & Drew, E. & Friedmann, P. & Trigg, H.L. & Robinson, J.W., 1991. "A randomized trial of an interim methadone maintenance clinic," American Journal of Public Health, American Public Health Association, vol. 81(9), pages 1185-1191.
    2. Adriani Nikolakopoulou & Julian P T Higgins & Theodoros Papakonstantinou & Anna Chaimani & Cinzia Del Giovane & Matthias Egger & Georgia Salanti, 2020. "CINeMA: An approach for assessing confidence in the results of a network meta-analysis," PLOS Medicine, Public Library of Science, vol. 17(4), pages 1-19, April.
    3. David J. Spiegelhalter & Nicola G. Best & Bradley P. Carlin & Angelika Van Der Linde, 2002. "Bayesian measures of model complexity and fit," Journal of the Royal Statistical Society Series B, Royal Statistical Society, vol. 64(4), pages 583-639, October.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Buddhavarapu, Prasad & Bansal, Prateek & Prozzi, Jorge A., 2021. "A new spatial count data model with time-varying parameters," Transportation Research Part B: Methodological, Elsevier, vol. 150(C), pages 566-586.
    2. Mumtaz, Haroon & Theodoridis, Konstantinos, 2017. "Common and country specific economic uncertainty," Journal of International Economics, Elsevier, vol. 105(C), pages 205-216.
    3. Christina Leuker & Thorsten Pachur & Ralph Hertwig & Timothy J. Pleskac, 2019. "Do people exploit risk–reward structures to simplify information processing in risky choice?," Journal of the Economic Science Association, Springer;Economic Science Association, vol. 5(1), pages 76-94, August.
    4. Rubio, F.J. & Steel, M.F.J., 2011. "Inference for grouped data with a truncated skew-Laplace distribution," Computational Statistics & Data Analysis, Elsevier, vol. 55(12), pages 3218-3231, December.
    5. Alessandri, Piergiorgio & Mumtaz, Haroon, 2019. "Financial regimes and uncertainty shocks," Journal of Monetary Economics, Elsevier, vol. 101(C), pages 31-46.
    6. Svetlana V. Tishkovskaya & Paul G. Blackwell, 2021. "Bayesian estimation of heterogeneous environments from animal movement data," Environmetrics, John Wiley & Sons, Ltd., vol. 32(6), September.
    7. Leonardo Oliveira Martins & Hirohisa Kishino, 2010. "Distribution of distances between topologies and its effect on detection of phylogenetic recombination," Annals of the Institute of Statistical Mathematics, Springer;The Institute of Statistical Mathematics, vol. 62(1), pages 145-159, February.
    8. Tamal Ghosh & Malay Ghosh & Jerry J. Maples & Xueying Tang, 2022. "Multivariate Global-Local Priors for Small Area Estimation," Stats, MDPI, vol. 5(3), pages 1-16, July.
    9. Fourrier-Nicolaï Edwin & Lubrano Michel, 2024. "Bayesian inference for non-anonymous growth incidence curves using Bernstein polynomials: an application to academic wage dynamics," Studies in Nonlinear Dynamics & Econometrics, De Gruyter, vol. 28(2), pages 319-336, April.
    10. Eibich, Peter & Ziebarth, Nicolas, 2014. "Examining the Structure of Spatial Health Effects in Germany Using Hierarchical Bayes Models," EconStor Open Access Articles and Book Chapters, ZBW - Leibniz Information Centre for Economics, vol. 49, pages 305-320.
    11. Wu, Ji & Guo, Mengmeng & Chen, Minghua & Jeon, Bang Nam, 2019. "Market power and risk-taking of banks: Some semiparametric evidence from emerging economies," Emerging Markets Review, Elsevier, vol. 41(C).
    12. repec:jss:jstsof:21:i08 is not listed on IDEAS
    13. Deng, Yaguo & Lopes Moreira da Veiga, María Helena & Wiper, Michael Peter, 2016. "Efficiency evaluation of Spanish hotel chains," DES - Working Papers. Statistics and Econometrics. WS 23897, Universidad Carlos III de Madrid. Departamento de Estadística.
    14. Cathy W. S. Chen & Sangyeol Lee, 2017. "Bayesian causality test for integer-valued time series models with applications to climate and crime data," Journal of the Royal Statistical Society Series C, Royal Statistical Society, vol. 66(4), pages 797-814, August.
    15. Makoto Chikaraishi & Akimasa Fujiwara & Junyi Zhang & Kay Axhausen, 2011. "Identifying variations and co-variations in discrete choice models," Transportation, Springer, vol. 38(6), pages 993-1016, November.
    16. Galatia Cleanthous & Emilio Porcu & Philip White, 2021. "Regularity and approximation of Gaussian random fields evolving temporally over compact two-point homogeneous spaces," TEST: An Official Journal of the Spanish Society of Statistics and Operations Research, Springer;Sociedad de Estadística e Investigación Operativa, vol. 30(4), pages 836-860, December.
    17. Baños-Pino, José F. & Boto-García, David & Zapico, Emma, 2021. "Persistence and dynamics in the efficiency of toll motorways: The Spanish case," Efficiency Series Papers 2021/03, University of Oviedo, Department of Economics, Oviedo Efficiency Group (OEG).
    18. Xing Ju Lee & Christopher C. Drovandi & Anthony N. Pettitt, 2015. "Model choice problems using approximate Bayesian computation with applications to pathogen transmission data sets," Biometrics, The International Biometric Society, vol. 71(1), pages 198-207, March.
    19. Chaix, Basile & Jouven, Xavier & Thomas, Frédérique & Leal, Cinira & Billaudeau, Nathalie & Bean, Kathy & Kestens, Yan & Jëgo, Bertrand & Pannier, Bruno & Danchin, Nicolas, 2011. "Why socially deprived populations have a faster resting heart rate: Impact of behaviour, life course anthropometry, and biology – the RECORD Cohort Study," Social Science & Medicine, Elsevier, vol. 73(10), pages 1543-1550.
    20. Emilio Augusto Coelho-Barros & Jorge Alberto Achcar & Josmar Mazucheli, 2010. "Longitudinal Poisson modeling: an application for CD4 counting in HIV-infected patients," Journal of Applied Statistics, Taylor & Francis Journals, vol. 37(5), pages 865-880.
    21. Mayer Alvo & Jingrui Mu, 2023. "COVID-19 Data Analysis Using Bayesian Models and Nonparametric Geostatistical Models," Mathematics, MDPI, vol. 11(6), pages 1-13, March.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0266142. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.