Treatments Compared for Neonatal Abstinence Syndrome

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Buprenorphine significantly more effective than morphine in NAS
Buprenorphine significantly more effective than morphine in NAS

(HealthDay News) — Sublingual buprenorphine is associated with shorter duration of treatment than oral morphine for infants with neonatal abstinence syndrome, according to a study published online May 4 in the New England Journal of Medicine. The research was published to coincide with the annual meeting of the Pediatric Academic Societies, held from May 6 to 9 in San Francisco.

Walter K. Kraft, M.D., from the Sidney Kimmel Medical College at Thomas Jefferson University in Philadelphia, and colleagues conducted a double-blind, double-dummy clinical trial involving 63 term infants who had been exposed to opioids in utero and had signs of neonatal abstinence syndrome. The infants were randomized to receive sublingual buprenorphine or oral morphine. Adjunctive phenobarbital was used to treat infants with symptoms that were not controlled with the maximum dose of opioid.

The researchers found that, compared with morphine, buprenorphine correlated with significantly shorter median duration of treatment (15 versus 28 days) and median length of hospital stay (21 versus 33 days) (both P < 0.001). Adjunctive phenobarbital was administered to 15 and 23 percent of infants in the buprenorphine and morphine groups, respectively (P = 0.36). Similar rates of adverse events were seen in the groups.

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"Among infants with the neonatal abstinence syndrome, treatment with sublingual buprenorphine resulted in a shorter duration of treatment and shorter length of hospital stay than treatment with oral morphine, with similar rates of adverse events," the authors write.

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