liu.seSearch for publications in DiVA
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Assessment of pioglitazone and proinflammatory cytokines during buprenorphine taper in patients with opioid use disorder
Johns Hopkins Bayview Med Ctr, MD 21224 USA.
NIDA, MD 21224 USA.
NIDA, MD 21224 USA.
NIDA, MD 21224 USA.
Show others and affiliations
2018 (English)In: Psychopharmacology, ISSN 0033-3158, E-ISSN 1432-2072, Vol. 235, no 10, p. 2957-2966Article in journal (Refereed) Published
Abstract [en]

Background Preliminary evidence suggested that the PPAR gamma agonist pioglitazone reduces opioid-withdrawal symptoms, possibly by inhibiting increases in proinflammatory cytokines. Methods A randomized, placebo-controlled clinical trial was conducted utilizing two different study designs (entirely outpatient, and a combination of inpatient and outpatient) to evaluate the safety and efficacy of pioglitazone as an adjunct medication for people with opioid physical dependence undergoing a buprenorphine taper. Participants were stabilized on buprenorphine/naloxone (sublingual, up to 16/4 mg/day), then randomized to receive oral pioglitazone (up to 45 mg/day) or placebo before, during, and after buprenorphine taper. Outcome measures included the Subjective Opiate Withdrawal Scale (SOWS) and Clinical Opiate Withdrawal Scale, use of rescue medications to alleviate opioid withdrawal symptoms, and opioid-positive urine specimens. Cerebrospinal fluid (CSF) and plasma were collected during the taper in a subset of participants for measurement of proinflammatory cytokines. Results The clinical trial was prematurely terminated due to slow enrollment; 40 participants per group were required for adequate statistical power to test study hypotheses. Twenty-four participants enrolled; 17 received at least one dose of study medication (6 pioglitazone, 11 placebo). SOWS scores were higher in the pioglitazone arm than in the placebo arm after adjusting for use of rescue medications; participants in the pioglitazone arm needed more rescue medications than the placebo arm during the post-taper phase. SOWS scores were positively correlated with monocyte chemoattractant protein-1 (MCP-1) in CSF (r = 0.70, p = 0.038) and plasma (r = 0.77, p = 0.015). Participants having higher levels of plasma MCP-1 reported higher SOWS, most notably after the buprenorphine taper ended. Conclusions Results from this study provide no evidence that pioglitazone reduces opioid withdrawal symptoms during buprenorphine taper. High correlations between MCP-1 and opioid withdrawal symptoms support a role of proinflammatory processes in opioid withdrawal.

Place, publisher, year, edition, pages
SPRINGER , 2018. Vol. 235, no 10, p. 2957-2966
Keywords [en]
Pioglitazone; Buprenorphine; Opioid withdrawal; Cytokines; Opioid dependence
National Category
Neurology
Identifiers
URN: urn:nbn:se:liu:diva-152394DOI: 10.1007/s00213-018-4986-5ISI: 000446140500014PubMedID: 30079432OAI: oai:DiVA.org:liu-152394DiVA, id: diva2:1259624
Note

Funding Agencies|Intramural Research Program of the National Institute on Drug Abuse, National Institutes of Health; Swedish Research Council

Available from: 2018-10-30 Created: 2018-10-30 Last updated: 2018-10-30

Open Access in DiVA

No full text in DiVA

Other links

Publisher's full textPubMed

Search in DiVA

By author/editor
Heilig, Markus
By organisation
Center for Social and Affective NeuroscienceFaculty of Medicine and Health SciencesDepartment of Psychiatry
In the same journal
Psychopharmacology
Neurology

Search outside of DiVA

GoogleGoogle Scholar

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 4 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf