Relationship between plasma concentrations of the l-enantiomer of methadone and response to methadone maintenance treatment
This study evaluated the relationship between the plasma concentration of l-methadone and response to methadone in real-world patients, in order to identify a minimum plasma concentration above which methadone treatment is effective. Ninety-four patients with opioid dependence under maintenance meth...
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| Veröffentlicht in: | European journal of pharmacology 2015-08, Vol.760, p.1-6 |
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| container_title | European journal of pharmacology |
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| creator | Meini, Milo Moncini, Marco Daini, Laura Giarratana, Tania Scaramelli, Daniela Chericoni, Silvio Stefanelli, Fabio Rucci, Paola |
| description | This study evaluated the relationship between the plasma concentration of l-methadone and response to methadone in real-world patients, in order to identify a minimum plasma concentration above which methadone treatment is effective.
Ninety-four patients with opioid dependence under maintenance methadone treatment were consecutively recruited. Response was defined as negative urine analyses in the three weeks prior to the blood sampling. The percentage of participants with a plasma l-methadone concentration between 100 and 250ng/ml was 54.2% among those with a methadone dosage ≥60mg/day. Plasma l-methadone concentrations were significantly higher in patients with negative urine analyses compared with those with positive urine analyses (median 93 vs. 77ng/ml, Mann–Whitney test, P |
| doi_str_mv | 10.1016/j.ejphar.2015.03.081 |
| format | Article |
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Ninety-four patients with opioid dependence under maintenance methadone treatment were consecutively recruited. Response was defined as negative urine analyses in the three weeks prior to the blood sampling. The percentage of participants with a plasma l-methadone concentration between 100 and 250ng/ml was 54.2% among those with a methadone dosage ≥60mg/day. Plasma l-methadone concentrations were significantly higher in patients with negative urine analyses compared with those with positive urine analyses (median 93 vs. 77ng/ml, Mann–Whitney test, P<0.05). Above plasma l-methadone concentrations of 200ng/ml no heroin use was reported and urine analyses were negative. Moreover, above concentrations of 250ng/ml craving was absent. Examination of demographic correlates of treatment outcome indicated that older age, a stable job and being married were protective against the use of heroin. Mean plasma l-methadone concentration was significantly lower in patients who used cannabis compared with those who did not use cannabis, after adjusting for methadone dosage.
In conclusion our results identify specific cut-offs for plasma l-methadone concentrations about which therapeutic response is observed and provide new evidence that therapeutic response is associated with patient׳s demographic characteristics. This underscores the need to monitor plasma methadone concentrations as part of Drug Addiction Services routine practice, in order to provide an objective framework for changing the methadone dosage.</description><identifier>ISSN: 0014-2999</identifier><identifier>EISSN: 1879-0712</identifier><identifier>DOI: 10.1016/j.ejphar.2015.03.081</identifier><identifier>PMID: 25891369</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Adult ; Cross-Sectional Studies ; Heroin Dependence - blood ; Heroin Dependence - diagnosis ; Heroin Dependence - drug therapy ; Humans ; Maintenance treatment ; Methadone ; Methadone - blood ; Methadone - chemistry ; Methadone - therapeutic use ; Middle Aged ; Opiate Substitution Treatment - methods ; Opioid-Related Disorders - blood ; Opioid-Related Disorders - diagnosis ; Opioid-Related Disorders - drug therapy ; Plasma methadone concentration ; Stereoisomerism ; Treatment Outcome ; Young Adult</subject><ispartof>European journal of pharmacology, 2015-08, Vol.760, p.1-6</ispartof><rights>2015 Elsevier B.V.</rights><rights>Copyright © 2015 Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c408t-77939165ef5c03cab6f201cdf619275bcb2247863c29cb94ee777dc7283977cd3</citedby><cites>FETCH-LOGICAL-c408t-77939165ef5c03cab6f201cdf619275bcb2247863c29cb94ee777dc7283977cd3</cites><orcidid>0000-0002-7704-0831</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ejphar.2015.03.081$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,777,781,3537,27905,27906,45976</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25891369$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Meini, Milo</creatorcontrib><creatorcontrib>Moncini, Marco</creatorcontrib><creatorcontrib>Daini, Laura</creatorcontrib><creatorcontrib>Giarratana, Tania</creatorcontrib><creatorcontrib>Scaramelli, Daniela</creatorcontrib><creatorcontrib>Chericoni, Silvio</creatorcontrib><creatorcontrib>Stefanelli, Fabio</creatorcontrib><creatorcontrib>Rucci, Paola</creatorcontrib><title>Relationship between plasma concentrations of the l-enantiomer of methadone and response to methadone maintenance treatment</title><title>European journal of pharmacology</title><addtitle>Eur J Pharmacol</addtitle><description>This study evaluated the relationship between the plasma concentration of l-methadone and response to methadone in real-world patients, in order to identify a minimum plasma concentration above which methadone treatment is effective.
Ninety-four patients with opioid dependence under maintenance methadone treatment were consecutively recruited. Response was defined as negative urine analyses in the three weeks prior to the blood sampling. The percentage of participants with a plasma l-methadone concentration between 100 and 250ng/ml was 54.2% among those with a methadone dosage ≥60mg/day. Plasma l-methadone concentrations were significantly higher in patients with negative urine analyses compared with those with positive urine analyses (median 93 vs. 77ng/ml, Mann–Whitney test, P<0.05). Above plasma l-methadone concentrations of 200ng/ml no heroin use was reported and urine analyses were negative. Moreover, above concentrations of 250ng/ml craving was absent. Examination of demographic correlates of treatment outcome indicated that older age, a stable job and being married were protective against the use of heroin. Mean plasma l-methadone concentration was significantly lower in patients who used cannabis compared with those who did not use cannabis, after adjusting for methadone dosage.
In conclusion our results identify specific cut-offs for plasma l-methadone concentrations about which therapeutic response is observed and provide new evidence that therapeutic response is associated with patient׳s demographic characteristics. This underscores the need to monitor plasma methadone concentrations as part of Drug Addiction Services routine practice, in order to provide an objective framework for changing the methadone dosage.</description><subject>Adult</subject><subject>Cross-Sectional Studies</subject><subject>Heroin Dependence - blood</subject><subject>Heroin Dependence - diagnosis</subject><subject>Heroin Dependence - drug therapy</subject><subject>Humans</subject><subject>Maintenance treatment</subject><subject>Methadone</subject><subject>Methadone - blood</subject><subject>Methadone - chemistry</subject><subject>Methadone - therapeutic use</subject><subject>Middle Aged</subject><subject>Opiate Substitution Treatment - methods</subject><subject>Opioid-Related Disorders - blood</subject><subject>Opioid-Related Disorders - diagnosis</subject><subject>Opioid-Related Disorders - drug therapy</subject><subject>Plasma methadone concentration</subject><subject>Stereoisomerism</subject><subject>Treatment Outcome</subject><subject>Young Adult</subject><issn>0014-2999</issn><issn>1879-0712</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMFq3DAQhkVJ6W62fYMSdMzFjiTbknUplCVtAguF0p6FLI9ZLbbkSNqE0pePFm9CTjkNzHz_DPMh9JWSkhLKbw4lHOa9DiUjtClJVZKWfkBr2gpZEEHZBVoTQuuCSSlX6DLGAyGkkaz5hFasaSWtuFyj_79h1Ml6F_d2xh2kJwCH51HHSWPjnQGXwgJgP-C0BzwW4LTLrQnCqTdB2uveO8Da9ThAnDMMOPk3k0lbl04xkwcBdJry3s_o46DHCF_OdYP-_rj9s70rdr9-3m-_7wpTkzYVQshKUt7A0BhSGd3xIb9s-oFTyUTTmY6xWrS8MkyaTtYAQojeCNZWUgjTVxt0veydg384QkxqstHAOGoH_hgV5S2XsmYNz2i9oCb4GAMMag520uGfokSdtKuDWrSrk3ZFKpW159jV-cKxm6B_Db14zsC3BYD856OFoKKxkG30NoBJqvf2_QvPkdOYPQ</recordid><startdate>20150805</startdate><enddate>20150805</enddate><creator>Meini, Milo</creator><creator>Moncini, Marco</creator><creator>Daini, Laura</creator><creator>Giarratana, Tania</creator><creator>Scaramelli, Daniela</creator><creator>Chericoni, Silvio</creator><creator>Stefanelli, Fabio</creator><creator>Rucci, Paola</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7704-0831</orcidid></search><sort><creationdate>20150805</creationdate><title>Relationship between plasma concentrations of the l-enantiomer of methadone and response to methadone maintenance treatment</title><author>Meini, Milo ; Moncini, Marco ; Daini, Laura ; Giarratana, Tania ; Scaramelli, Daniela ; Chericoni, Silvio ; Stefanelli, Fabio ; Rucci, Paola</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c408t-77939165ef5c03cab6f201cdf619275bcb2247863c29cb94ee777dc7283977cd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Cross-Sectional Studies</topic><topic>Heroin Dependence - blood</topic><topic>Heroin Dependence - diagnosis</topic><topic>Heroin Dependence - drug therapy</topic><topic>Humans</topic><topic>Maintenance treatment</topic><topic>Methadone</topic><topic>Methadone - blood</topic><topic>Methadone - chemistry</topic><topic>Methadone - therapeutic use</topic><topic>Middle Aged</topic><topic>Opiate Substitution Treatment - methods</topic><topic>Opioid-Related Disorders - blood</topic><topic>Opioid-Related Disorders - diagnosis</topic><topic>Opioid-Related Disorders - drug therapy</topic><topic>Plasma methadone concentration</topic><topic>Stereoisomerism</topic><topic>Treatment Outcome</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Meini, Milo</creatorcontrib><creatorcontrib>Moncini, Marco</creatorcontrib><creatorcontrib>Daini, Laura</creatorcontrib><creatorcontrib>Giarratana, Tania</creatorcontrib><creatorcontrib>Scaramelli, Daniela</creatorcontrib><creatorcontrib>Chericoni, Silvio</creatorcontrib><creatorcontrib>Stefanelli, Fabio</creatorcontrib><creatorcontrib>Rucci, Paola</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of pharmacology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Meini, Milo</au><au>Moncini, Marco</au><au>Daini, Laura</au><au>Giarratana, Tania</au><au>Scaramelli, Daniela</au><au>Chericoni, Silvio</au><au>Stefanelli, Fabio</au><au>Rucci, Paola</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Relationship between plasma concentrations of the l-enantiomer of methadone and response to methadone maintenance treatment</atitle><jtitle>European journal of pharmacology</jtitle><addtitle>Eur J Pharmacol</addtitle><date>2015-08-05</date><risdate>2015</risdate><volume>760</volume><spage>1</spage><epage>6</epage><pages>1-6</pages><issn>0014-2999</issn><eissn>1879-0712</eissn><abstract>This study evaluated the relationship between the plasma concentration of l-methadone and response to methadone in real-world patients, in order to identify a minimum plasma concentration above which methadone treatment is effective.
Ninety-four patients with opioid dependence under maintenance methadone treatment were consecutively recruited. Response was defined as negative urine analyses in the three weeks prior to the blood sampling. The percentage of participants with a plasma l-methadone concentration between 100 and 250ng/ml was 54.2% among those with a methadone dosage ≥60mg/day. Plasma l-methadone concentrations were significantly higher in patients with negative urine analyses compared with those with positive urine analyses (median 93 vs. 77ng/ml, Mann–Whitney test, P<0.05). Above plasma l-methadone concentrations of 200ng/ml no heroin use was reported and urine analyses were negative. Moreover, above concentrations of 250ng/ml craving was absent. Examination of demographic correlates of treatment outcome indicated that older age, a stable job and being married were protective against the use of heroin. Mean plasma l-methadone concentration was significantly lower in patients who used cannabis compared with those who did not use cannabis, after adjusting for methadone dosage.
In conclusion our results identify specific cut-offs for plasma l-methadone concentrations about which therapeutic response is observed and provide new evidence that therapeutic response is associated with patient׳s demographic characteristics. This underscores the need to monitor plasma methadone concentrations as part of Drug Addiction Services routine practice, in order to provide an objective framework for changing the methadone dosage.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>25891369</pmid><doi>10.1016/j.ejphar.2015.03.081</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-7704-0831</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Cross-Sectional Studies Heroin Dependence - blood Heroin Dependence - diagnosis Heroin Dependence - drug therapy Humans Maintenance treatment Methadone Methadone - blood Methadone - chemistry Methadone - therapeutic use Middle Aged Opiate Substitution Treatment - methods Opioid-Related Disorders - blood Opioid-Related Disorders - diagnosis Opioid-Related Disorders - drug therapy Plasma methadone concentration Stereoisomerism Treatment Outcome Young Adult |
| title | Relationship between plasma concentrations of the l-enantiomer of methadone and response to methadone maintenance treatment |
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