Weekly dosing with extended-release buprenorphine may result in greater rates of abstinence than daily sublingual dosing in pregnant adults with opioid use disorder (OUD), according to a study in JAMA Internal Medicine.Why It’s Relevant
Weekly, in-clinic dosing may address some of the disadvantages of daily take-home dosing, including the risk of diversion and misuse, poor adherence, and fluctuating medication levels that may not fully lessen opioid cravings and withdrawal, especially during pregnancy.
By the Numbers
- The researchers analyzed data from 140 adults (ages 18 to 41, six to 30 weeks pregnant) with OUD. Participants received either weekly injections of extended-release buprenorphine or daily sublingual buprenorphine tablets and/or buprenorphine/naloxone film. Participants had their urine screened weekly.
- Medication adherence was about 85% in both groups during pregnancy, but abstinence from illicit opioids was higher in the extended-release group compared to the sublingual group, 83% versus 73%.
- Participants in the extended-release group experienced fewer serious adverse events, such as initial or prolonged hospitalization, than those given daily dosing, both during pregnancy (9% versus 27%, respectively) and twelve months postpartum (6% versus 19%, respectively).
What’s More
There was no significant difference in the number of infants who required opioid treatment for neonatal opioid withdrawal syndrome between the extended-release group (30%) and sublingual group (27%).
The Other Side
Most of the study participants were taking sublingual buprenorphine before they were randomized. Therefore, it’s not clear whether the findings apply to a more unstable population with OUD or to patients who are initiating buprenorphine.
Takeaway Message
“The superior illicit opioid abstinence observed in the extended-release buprenorphine group potentially is related to its pharmacokinetic advantages,” the researchers wrote. “These results support the use of weekly extended-release buprenorphine in pregnant individuals with OUD.”
Related Information
Source
T. John Winhusen, et al. Extended-release vs sublingual buprenorphine in pregnancy through 12 months post partum: a randomized clinical trial. JAMA Internal Medicine. Published online March 16, 2026. doi: 10.1001/jamainternmed.2026.0057
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