A new study has determined that buprenorphine, an opioid that is safer than high-dose full agonist opioid therapy, can be used in patients with sickle cell disease (SCD).
The study, published in the American Journal of Hematology, employed a transitioning protocol developed by the researchers in 36 patients to convert from chronic opioid therapy to buprenorphine while reducing adverse events.
Over the last 10 years, the research team has developed a reproducible outpatient process for converting patients from chronic opioid therapy to buprenorphine, which offers pain relief with a lower risk of tolerance, withdrawal, and overdose. They described the experience of patients transitioning to buprenorphine after having a poor response to chronic opioid therapy.
The patients were seen weekly and were individually weaned off of chronic opioid therapy as needed to achieve a target preinduction dose of 90 mg of oral morphine equivalents, with the aim of reducing withdrawal symptoms. Buprenorphine was initiated sublingually, and the dose was individually adjusted to manage pain based on patient ratings and the Clinical Opioid Withdrawal Score.
David MS, Jones J, Lauriello A, et al. Converting adults with sickle cell disease from full agonist opioids to buprenorphine: a reliable method with safety and early evidence of reduced acute care utilization. Am J Hematol. Published online August 26, 2022. doi:10.1002/ajh.26699