AIMS: We aimed to improve the retention in treatment and therapeutic outcome of methadone maintenance treatment (MMT) patients by adjusting the oral methadone dose in order to reach a "target" plasma R-methadone level (80-250 ng/mL). METHODS: A multicenter randomized controlled trial was organized. RESULTS: The intention-to-treat statistical analysis showed that repeated dose adjustments performed in order to obtain therapeutic plasma R-methadone levels did not improve retention in treatment of heroin-dependent patients. However, patients having plasma methadone levels in the "target range" at the beginning of the study had a better retention in treatment than controls. Furthermore, patients succeeding in keeping plasma R-methadone target levels (per protocol analysis) remained in treatment and improved their social scores better than controls. -Conclusion: Although the primary endpoint of this study was not demonstrated, a post hoc and a per protocol analysis suggested that patients in MMT with plasma R-methadone concentrations in the target range have a better therapeutic outcome than controls.

Methadone Dose Adjustments, Plasma R-Methadone Levels and Therapeutic Outcome of Heroin Users: A Randomized Clinical Trial / Mannaioni, Guido; Lanzi, Cecilia; Lotti, Michela; Galli, Valentina; Totti, Arianna; Pacileo, Ilaria; Sili, Maria; Pracucci, Chiara; Dilaghi, Arianna; Bertieri, Lara; Quaranta, Mariarita; Orsini, Francesco; Occupati, Brunella; Michahelles, Assia; Ciuti, Riccardo; Bianchini, Elisa; Fabbro, Giancarlo; Biggeri, Annibale; Masini, Emanuela; Moroni, Flavio. - In: EUROPEAN ADDICTION RESEARCH. - ISSN 1022-6877. - ELETTRONICO. - 24:(2018), pp. 9-18. [10.1159/000485029]

Methadone Dose Adjustments, Plasma R-Methadone Levels and Therapeutic Outcome of Heroin Users: A Randomized Clinical Trial

Mannaioni, Guido;Lanzi, Cecilia;LOTTI, MICHELA;Galli, Valentina;TOTTI, ARIANNA;PACILEO, ILARIA;Sili, Maria;Pracucci, Chiara;Dilaghi, Arianna;Bertieri, Lara;ORSINI, FRANCESCO;Occupati, Brunella;MICHAHELLES, ASSIA;Ciuti, Riccardo;Bianchini, Elisa;Fabbro, Giancarlo;Biggeri, Annibale;Masini, Emanuela;Moroni, Flavio
2018

Abstract

AIMS: We aimed to improve the retention in treatment and therapeutic outcome of methadone maintenance treatment (MMT) patients by adjusting the oral methadone dose in order to reach a "target" plasma R-methadone level (80-250 ng/mL). METHODS: A multicenter randomized controlled trial was organized. RESULTS: The intention-to-treat statistical analysis showed that repeated dose adjustments performed in order to obtain therapeutic plasma R-methadone levels did not improve retention in treatment of heroin-dependent patients. However, patients having plasma methadone levels in the "target range" at the beginning of the study had a better retention in treatment than controls. Furthermore, patients succeeding in keeping plasma R-methadone target levels (per protocol analysis) remained in treatment and improved their social scores better than controls. -Conclusion: Although the primary endpoint of this study was not demonstrated, a post hoc and a per protocol analysis suggested that patients in MMT with plasma R-methadone concentrations in the target range have a better therapeutic outcome than controls.
2018
24
9
18
Mannaioni, Guido; Lanzi, Cecilia; Lotti, Michela; Galli, Valentina; Totti, Arianna; Pacileo, Ilaria; Sili, Maria; Pracucci, Chiara; Dilaghi, Arianna; Bertieri, Lara; Quaranta, Mariarita; Orsini, Francesco; Occupati, Brunella; Michahelles, Assia; Ciuti, Riccardo; Bianchini, Elisa; Fabbro, Giancarlo; Biggeri, Annibale; Masini, Emanuela; Moroni, Flavio
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Utilizza questo identificatore per citare o creare un link a questa risorsa: https://hdl.handle.net/2158/1113273
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