Cochrane · systematic review · CD002025

Buprenorphine for managing opioid withdrawal

Gowing, L, Ali, R, White, JM, et al. · Cochrane Database of Systematic Reviews · 2017 · Cochrane Library

Drugs and Alcohol2 versionsAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
12
current version
GRADE rated
12
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 4 · 33.3%Low 4 · 33.3%Moderate 4 · 33.3%High 0 · 0%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Questions and results

Show all 2 versions

Buprenorphine vs methadone for managing opioid withdrawal

Population: Adults with opioid dependence
2 questions
OutcomeEffectEvidenceStatus / GRADE
Mean days in treatment
Buprenorphine vs methadone
no estimate extracted2 studies · 82 participantsLow
Downgraded: imprecision
Completion of withdrawal treatment
Buprenorphine vs methadone
RR 1.04 [0.91, 1.2]5 studies · 457 participantsModerate
Downgraded: imprecision

Buprenorphine vs alpha2‐adrenergic agonists for managing opioid withdrawal

Population: Adults or adolescents with opioid dependence
6 questions
OutcomeEffectEvidenceStatus / GRADE
Mean peak withdrawal score,
Buprenorphine vs alpha2‐adrenergic agonists
no estimate extracted6 studies · 521 participantsVery low
Downgraded: risk of bias, imprecision, inconsistency
Mean overall withdrawal score, with various methods of assessment
Buprenorphine vs alpha2‐adrenergic agonists
no estimate extracted7 studies · 902 participantsModerate
Downgraded: risk of bias
Mean days in treatment (with varying scheduled duration)
Buprenorphine vs alpha2‐adrenergic agonists
SMD 0.92 [0.57, 1.27]4 studies · 558 participantsModerate
Downgraded: inconsistency
Number experiencing adverse effects
Buprenorphine vs alpha2‐adrenergic agonists
RR 0.93 [0.7, 1.26]3 studies · 493 participantsVery low
Downgraded: risk of bias, imprecision
Number with treatment stopped due to adverse effects
Buprenorphine vs alpha2‐adrenergic agonists
RR 0.2 [0.04, 1.15]3 studies · 134 participantsLow
Downgraded: imprecision
Number completing withdrawal treatment
Buprenorphine vs alpha2‐adrenergic agonists
RR 1.59 [1.23, 2.06]11 studies · 1264 participantsModerate
Downgraded: inconsistency

Rapid vs slow taper of buprenorphine dose for managing opioid withdrawal

Population: Adults or adolescents with opioid dependence
4 questions
OutcomeEffectEvidenceStatus / GRADE
Completion of withdrawal treatment − Inpatient
Rapid vs slow taper of buprenorphine dose
RR 1 [0.84, 1.18]2 studies · 60 participantsLow
Downgraded: imprecision
Completion of withdrawal treatment − Outpatient
Rapid vs slow taper of buprenorphine dose
RR 0.86 [0.44, 1.7]4 studies · 647 participantsVery low
Downgraded: inconsistency
Number abstinent at completion of dose taper − Inpatient
Rapid vs slow taper of buprenorphine dose
RR 1 [0.81, 1.23]1 study · 40 participantsLow
Downgraded: imprecision
Number abstinent at completion of dose taper − Outpatient
Rapid vs slow taper of buprenorphine dose
RR 0.94 [0.39, 2.24]4 studies · 619 participantsVery low
Downgraded: inconsistency