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Findings from a pilot study of buprenorphine population pharmacokinetics: A potential effect of HIV on buprenorphine bioavailability

Bart Department of Medicine, Hennepin Healthcare, 701 Park Avenue, MN, Minneapolis, 55415, United States|
P. Todd (6602584248) | Richard C. (7003818004); Korthuis | Le Minh (57571112000); Brundage Department of Medicine, Section of Addiction Medicine, Oregon Health & Science University School of Medicine, 3181 SW Sam Jackson Park Rd, OR, Portland, 97239, United States| Mutaz (57214884846); Giang Center for Training and Research on Substance Abuse and HIV, Hanoi Medical University, 1 Ton That Tung, Hanoi, Viet Nam| Gavin (7003963462); Jaber Department of Experimental and Clinical Pharmacology, University of Minnesota College of Pharmacy, 417 Delaware Street SE, MN, Minneapolis, 55455, United States|

Drug and Alcohol Dependence Số , năm 2022 (Tập 241, trang -)

ISSN: 3768716

ISSN: 3768716

DOI: 10.1016/j.drugalcdep.2022.109696

Tài liệu thuộc danh mục:

Article

English

Từ khóa: buprenorphine; efavirenz; nevirapine; nonnucleoside reverse transcriptase inhibitor; RNA directed DNA polymerase inhibitor; adult; antiretroviral therapy; Article; blood sampling; body weight; compartment model; controlled study; drug bioavailability; drug clearance; drug dependence; drug distribution; female; first order rate constant; human; Human immunodeficiency virus infection; major clinical study; male; medication compliance; pilot study; population research; randomized controlled trial (topic); volume of distribution
Tóm tắt tiếng anh
Background: Buprenorphine is widely used in the treatment of opioid use disorder (OUD). There are few pharmacokinetic models of buprenorphine across diverse populations. Population pharmacokinetics (POPPK) allows for covariates to be included in pharmacokinetic studies, thereby opening the potential to evaluate the effect of comorbidities, medications, and other factors on buprenorphine pharmacokinetics. This pilot study used POPPK to explore buprenorphine pharmacokinetics in patients with and without HIV receiving buprenorphine for OUD. Methods: Plasma buprenorphine levels were measured in 54 patients receiving buprenorphine for OUD just prior to and 2–5 h following regular buprenorphine dosing. A linear one-compartment POPPK model with first-order estimation was used to evaluate buprenorphine clearance (CL/F) and volume of distribution (V/F). Covariates included weight and HIV status. Results: All HIV+ patients reported complete past-month adherence to taking antiretroviral therapy that included either efavirenz or nevirapine. Buprenorphine CL/F was 76% higher in HIV+ patients (n = 17) than HIV- patients (n = 37). Buprenorphine V/F was 41% higher in the HIV+ patients. Conclusions: POPPK can be used to model buprenorphine pharmacokinetics in a real-world clinical population. While interactions between ART and buprenorphine alter buprenorphine CL/F, we also found alteration in V/F. Proportionate changes in CL/F and V/F might indicate a primary effect on bioavailability (F) rather than two separate effects. These findings indicate reduced buprenorphine bioavailability in patients with HIV. © 2022 Elsevier B.V.

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