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
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
Current version onlyBuprenorphine vs methadone for managing opioid withdrawal
Population: Adults with opioid dependence
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mean days in treatment Buprenorphine vs methadone | no estimate extracted | 2 studies · 82 participants | Low Downgraded: imprecision |
Completion of withdrawal treatment Buprenorphine vs methadone | RR 1.04 [0.91, 1.2] | 5 studies · 457 participants | Moderate Downgraded: imprecision |
Buprenorphine vs alpha2‐adrenergic agonists for managing opioid withdrawal
Population: Adults or adolescents with opioid dependence
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mean peak withdrawal score, Buprenorphine vs alpha2‐adrenergic agonists | no estimate extracted | 6 studies · 521 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Mean overall withdrawal score, with various methods of assessment Buprenorphine vs alpha2‐adrenergic agonists | no estimate extracted | 7 studies · 902 participants | Moderate 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 participants | Moderate Downgraded: inconsistency |
Number experiencing adverse effects Buprenorphine vs alpha2‐adrenergic agonists | RR 0.93 [0.7, 1.26] | 3 studies · 493 participants | Very 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 participants | Low Downgraded: imprecision |
Number completing withdrawal treatment Buprenorphine vs alpha2‐adrenergic agonists | RR 1.59 [1.23, 2.06] | 11 studies · 1264 participants | Moderate Downgraded: inconsistency |
Rapid vs slow taper of buprenorphine dose for managing opioid withdrawal
Population: Adults or adolescents with opioid dependence
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Completion of withdrawal treatment − Inpatient Rapid vs slow taper of buprenorphine dose | RR 1 [0.84, 1.18] | 2 studies · 60 participants | Low Downgraded: imprecision |
Completion of withdrawal treatment − Outpatient Rapid vs slow taper of buprenorphine dose | RR 0.86 [0.44, 1.7] | 4 studies · 647 participants | Very 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 participants | Low 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 participants | Very low Downgraded: inconsistency |
Buprenorphine vs methadone
Population: patients with the management of opioid withdrawal
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mean days in treatment Buprenorphine vs methadone | no estimate extracted | 2 studies · 82 participants | Moderate |
Completion of withdrawal Buprenorphine vs methadone | RR 1.18 [0.93, 1.49] | 4 studies · 168 participants | Low |
Buprenorphine vs adrenergic agonists
Population: patients with the management of opioid withdrawal
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mean peak withdrawal score Buprenorphine vs adrenergic agonists | no estimate extracted | 4 studies · 432 participants | Moderate |
Mean overall withdrawal score (participant rated) Buprenorphine vs adrenergic agonists | no estimate extracted | 2 studies · 452 participants | Moderate |
Mean days in treatment Buprenorphine vs adrenergic agonists | no estimate extracted | 4 studies · 558 participants | Moderate |
Number experiencing adverse effects Buprenorphine vs adrenergic agonists | RR 0.97 [0.76, 1.23] | 2 studies · 458 participants | Low |
Number withdrawn from treatment due to adverse effects Buprenorphine vs adrenergic agonists | RR 0.2 [0.04, 1.09] | 3 studies · 134 participants | Moderate |
Number completing withdrawal treatment Buprenorphine vs adrenergic agonists | RR 1.64 [1.31, 2.06] | 10 studies · 1206 participants | High |