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Meta-Analysis
. 2019 Nov;39(11):1535-1545.
doi: 10.1038/s41372-019-0437-3. Epub 2019 Jul 17.

Comparative effectiveness of opioid replacement agents for neonatal opioid withdrawal syndrome: a systematic review and meta-analysis

Jennifer J Lee  1 , Jerri Chen  1 , Lisa Eisler  1 , Guohua Li  1   2 , Jonathan M Davis  3   4 , Lena S Sun  5   6
Affiliations
Meta-Analysis

Comparative effectiveness of opioid replacement agents for neonatal opioid withdrawal syndrome: a systematic review and meta-analysis

Jennifer J Lee et al. J Perinatol. 2019 Nov.

Abstract

Objective(s): To compare short-term treatment outcomes of opioid pharmacotherapy for neonatal opioid withdrawal syndrome (NOWS).

Study design: PubMed/MEDLINE, Embase, PsycINFO, and The Cochrane Library were searched from inception through September 30, 2018. Primary outcome was treatment duration (LOT). Secondary outcomes included hospitalization duration (LOS) and rate of adjunct drug needed (RAD).

Results: Of 753 publications, 11 studies met inclusion criteria. There was no difference in LOT (WMD -1.39 [-5.79 to -3.01] days, I2 82%) or LOS (WMD -1.48 [-5.75 to -2.79] days, I2 92%) between morphine and methadone. RAD with morphine was higher (RR 1.51 [1.35-1.69], I2 0%). Buprenorphine was associated with shorter LOT (WMD 7.70 [0.88-14.53] days, I2 76%) and LOS (WMD 5.61 [-0.01 to -11.24] days, I2 60%) compared with morphine, in addition to methadone according to two cohort studies.

Conclusions: Methadone had superior primary treatment success compared with morphine. Buprenorphine was associated with the shortest overall durations of treatment and hospitalization.

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Conflict of interest statement

Conflict of interest The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
PRISMA Study Selection Flow Diagram. *Hall 2018 cohort study [20] compared treatment outcomes for morphine vs methadone vs buprenorphine therapies, which accounts for duplicate study numbers
Fig. 2
Fig. 2
Morphine vs methadone on length of treatment, length of hospitalization, and rate of adjunct drug use
Fig. 3
Fig. 3
Morphine vs buprenorphine on length of treatment, length of hospitalization, and rate of adjunct drug use
See this image and copyright information in PMC

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