Trial Outcomes & Findings for Extended-Release Naltrexone for Opioid Relapse Prevention Following Release From Jail (NCT NCT01180647)

NCT ID: NCT01180647

Last Updated: 2016-04-07

Results Overview

Post-release opioid relapse at week 4, measured by self-report (Time Line Follow Back) and urine toxicologies, and defined as ≥10 of 28 days of self-reported opioid misuse following jail release or two or three positive of the three urine samples during weeks 2, 3 and 4. A single positive or missing urine result counted as 7 opioid misuse days.

Recruitment status

COMPLETED

Study phase

PHASE3

Target enrollment

48 participants

Primary outcome timeframe

Four weeks post-release

Results posted on

2016-04-07

Participant Flow

Recruitment of participants took place at NYC jail medical clinics (Rikers Island; EMTC, RMSC) with follow-up visits taking place at Bellevue Hospital. The last participant completed in June 2013.

Of the 48 consented participants enrolled into study between January 2010-May 2013, 34 were randomized into one of two trial arms, with n=17 to Extended-Release Naltrexone arm and n=17 to the Motivational Enhancement Counseling Only arm (treatment-as-usual).

Participant milestones

Participant milestones
Measure
Extended-release Naltrexone (XR-NTX)
A single 380mg IM depot injection of XR-NTX in the week prior to release from jail. A second 380mg IM injection is offered to persons in the XR-NTX arm post-release and 4 weeks after the initial injection. Extended-Release Naltrexone: 380mg IM XR-NTX injection one week prior to release from jail; a second XR-NTX 380mg IM injection is offered 4 weeks later (monthly).
Motivational Enhancement Counseling Only
The randomized control arm receives no medication treatment and is offered brief, two-session Motivational Enhancement counseling prior to release from jail. Motivational Enhancement Counseling: The randomized control arm receives no medication treatment and is offered brief, two-session Motivational Enhancement counseling prior to release from jail.
Overall Study
STARTED
17
17
Overall Study
COMPLETED
12
11
Overall Study
NOT COMPLETED
5
6

Reasons for withdrawal

Reasons for withdrawal
Measure
Extended-release Naltrexone (XR-NTX)
A single 380mg IM depot injection of XR-NTX in the week prior to release from jail. A second 380mg IM injection is offered to persons in the XR-NTX arm post-release and 4 weeks after the initial injection. Extended-Release Naltrexone: 380mg IM XR-NTX injection one week prior to release from jail; a second XR-NTX 380mg IM injection is offered 4 weeks later (monthly).
Motivational Enhancement Counseling Only
The randomized control arm receives no medication treatment and is offered brief, two-session Motivational Enhancement counseling prior to release from jail. Motivational Enhancement Counseling: The randomized control arm receives no medication treatment and is offered brief, two-session Motivational Enhancement counseling prior to release from jail.
Overall Study
Lost to Follow-up
5
6

Baseline Characteristics

Extended-Release Naltrexone for Opioid Relapse Prevention Following Release From Jail

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Extended-release Naltrexone (XR-NTX)
n=16 Participants
A single 380mg IM depot injection of XR-NTX in the week prior to release from jail. A second 380mg IM injection is offered to persons in the XR-NTX arm post-release and 4 weeks after the initial injection. Extended-Release Naltrexone: 380mg IM XR-NTX injection one week prior to release from jail; a second XR-NTX 380mg IM injection is offered 4 weeks later (monthly).
Motivational Enhancement Counseling Only
n=17 Participants
The randomized control arm receives no medication treatment and is offered brief, two-session Motivational Enhancement counseling prior to release from jail. Motivational Enhancement Counseling: The randomized control arm receives no medication treatment and is offered brief, two-session Motivational Enhancement counseling prior to release from jail.
Total
n=33 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Age, Categorical
Between 18 and 65 years
16 Participants
n=99 Participants
17 Participants
n=107 Participants
33 Participants
n=206 Participants
Age, Categorical
>=65 years
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Age, Continuous
40 years
n=99 Participants
47 years
n=107 Participants
44 years
n=206 Participants
Sex: Female, Male
Female
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Sex: Female, Male
Male
16 Participants
n=99 Participants
17 Participants
n=107 Participants
33 Participants
n=206 Participants
Region of Enrollment
United States
16 participants
n=99 Participants
17 participants
n=107 Participants
33 participants
n=206 Participants

PRIMARY outcome

Timeframe: Four weeks post-release

Population: One XR-NTX participant randomized was excluded from final data analysis due to the fact he was never released from jail to community, so primary outcome (post-release opioid relapse) could not be measured.

Post-release opioid relapse at week 4, measured by self-report (Time Line Follow Back) and urine toxicologies, and defined as ≥10 of 28 days of self-reported opioid misuse following jail release or two or three positive of the three urine samples during weeks 2, 3 and 4. A single positive or missing urine result counted as 7 opioid misuse days.

Outcome measures

Outcome measures
Measure
Extended-release Naltrexone (XR-NTX)
n=16 Participants
A single 380mg IM depot injection of XR-NTX in the week prior to release from jail. A second 380mg IM injection is offered to persons in the XR-NTX arm post-release and 4 weeks after the initial injection. Extended-Release Naltrexone: 380mg IM XR-NTX injection one week prior to release from jail; a second XR-NTX 380mg IM injection is offered 4 weeks later (monthly).
Motivational Enhancement Counseling Only
n=17 Participants
The randomized control arm receives no medication treatment and is offered brief, two-session Motivational Enhancement counseling prior to release from jail. Motivational Enhancement Counseling: The randomized control arm receives no medication treatment and is offered brief, two-session Motivational Enhancement counseling prior to release from jail.
Post-Release Opioid Relapse
6 participants
Interval 1.0 to 16.0
15 participants
Interval 1.0 to 17.0

SECONDARY outcome

Timeframe: Four weeks post-release

Population: One XR-NTX participant who was randomized was excluded from final data analysis because he was never released from jail to community.

This secondary outcome tracks community drug treatment initiation four weeks post-release from jail. Measured by self-report community drug treatment initiation at week 4 study visit.

Outcome measures

Outcome measures
Measure
Extended-release Naltrexone (XR-NTX)
n=16 Participants
A single 380mg IM depot injection of XR-NTX in the week prior to release from jail. A second 380mg IM injection is offered to persons in the XR-NTX arm post-release and 4 weeks after the initial injection. Extended-Release Naltrexone: 380mg IM XR-NTX injection one week prior to release from jail; a second XR-NTX 380mg IM injection is offered 4 weeks later (monthly).
Motivational Enhancement Counseling Only
n=17 Participants
The randomized control arm receives no medication treatment and is offered brief, two-session Motivational Enhancement counseling prior to release from jail. Motivational Enhancement Counseling: The randomized control arm receives no medication treatment and is offered brief, two-session Motivational Enhancement counseling prior to release from jail.
Participation in Community Drug Treatment Post-release
19 percentage of participants
12 percentage of participants

SECONDARY outcome

Timeframe: Four weeks post-release

Population: One XR-NTX participant who was randomized was excluded from final data analysis because he was never released from jail to community.

Counts of any opioid use, defined as self-reported ≥ 1 day of heroin or other opioid use as measured by the Timeline Follow-Back assessment during the first 4 weeks post-release.

Outcome measures

Outcome measures
Measure
Extended-release Naltrexone (XR-NTX)
n=16 Participants
A single 380mg IM depot injection of XR-NTX in the week prior to release from jail. A second 380mg IM injection is offered to persons in the XR-NTX arm post-release and 4 weeks after the initial injection. Extended-Release Naltrexone: 380mg IM XR-NTX injection one week prior to release from jail; a second XR-NTX 380mg IM injection is offered 4 weeks later (monthly).
Motivational Enhancement Counseling Only
n=17 Participants
The randomized control arm receives no medication treatment and is offered brief, two-session Motivational Enhancement counseling prior to release from jail. Motivational Enhancement Counseling: The randomized control arm receives no medication treatment and is offered brief, two-session Motivational Enhancement counseling prior to release from jail.
Any Opioid Use Post-release
17 percentage of participants
82 percentage of participants

SECONDARY outcome

Timeframe: Four weeks post-release

This secondary outcome tracks any injection drug use and frequency of injection drug use in the four weeks following release from jail.

Outcome measures

Outcome measures
Measure
Extended-release Naltrexone (XR-NTX)
n=16 Participants
A single 380mg IM depot injection of XR-NTX in the week prior to release from jail. A second 380mg IM injection is offered to persons in the XR-NTX arm post-release and 4 weeks after the initial injection. Extended-Release Naltrexone: 380mg IM XR-NTX injection one week prior to release from jail; a second XR-NTX 380mg IM injection is offered 4 weeks later (monthly).
Motivational Enhancement Counseling Only
n=17 Participants
The randomized control arm receives no medication treatment and is offered brief, two-session Motivational Enhancement counseling prior to release from jail. Motivational Enhancement Counseling: The randomized control arm receives no medication treatment and is offered brief, two-session Motivational Enhancement counseling prior to release from jail.
Injection Drug Use Post-release
25 percentage of participants by arm
6 percentage of participants by arm

SECONDARY outcome

Timeframe: Four weeks post-release

Population: One XR-NTX participant who was randomized was excluded from final data analysis because he was never released from jail to community.

Accidental drug overdose is defined as patient self-report of any event consistent with over-sedation or respiratory suppression following ingestion of alcohol, prescription, or illicit drugs.

Outcome measures

Outcome measures
Measure
Extended-release Naltrexone (XR-NTX)
n=16 Participants
A single 380mg IM depot injection of XR-NTX in the week prior to release from jail. A second 380mg IM injection is offered to persons in the XR-NTX arm post-release and 4 weeks after the initial injection. Extended-Release Naltrexone: 380mg IM XR-NTX injection one week prior to release from jail; a second XR-NTX 380mg IM injection is offered 4 weeks later (monthly).
Motivational Enhancement Counseling Only
n=17 Participants
The randomized control arm receives no medication treatment and is offered brief, two-session Motivational Enhancement counseling prior to release from jail. Motivational Enhancement Counseling: The randomized control arm receives no medication treatment and is offered brief, two-session Motivational Enhancement counseling prior to release from jail.
Accidental Drug Overdose
0 participants
0 participants

SECONDARY outcome

Timeframe: Eight weeks post-release

Population: One XR-NTX participant who was randomized was excluded from final data analysis because he was never released from jail to community.

AEs and SAEs per standard definitions will be measured by self-report.

Outcome measures

Outcome measures
Measure
Extended-release Naltrexone (XR-NTX)
n=16 Participants
A single 380mg IM depot injection of XR-NTX in the week prior to release from jail. A second 380mg IM injection is offered to persons in the XR-NTX arm post-release and 4 weeks after the initial injection. Extended-Release Naltrexone: 380mg IM XR-NTX injection one week prior to release from jail; a second XR-NTX 380mg IM injection is offered 4 weeks later (monthly).
Motivational Enhancement Counseling Only
n=17 Participants
The randomized control arm receives no medication treatment and is offered brief, two-session Motivational Enhancement counseling prior to release from jail. Motivational Enhancement Counseling: The randomized control arm receives no medication treatment and is offered brief, two-session Motivational Enhancement counseling prior to release from jail.
Adverse Events and Serious Adverse Events
5 participants
1 participants

Adverse Events

Extended-release Naltrexone (XR-NTX)

Serious events: 0 serious events
Other events: 5 other events
Deaths: 0 deaths

Motivational Enhancement Counseling Only

Serious events: 0 serious events
Other events: 1 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Extended-release Naltrexone (XR-NTX)
n=16 participants at risk
A single 380mg IM depot injection of XR-NTX in the week prior to release from jail. A second 380mg IM injection is offered to persons in the XR-NTX arm post-release and 4 weeks after the initial injection. Extended-Release Naltrexone: 380mg IM XR-NTX injection one week prior to release from jail; a second XR-NTX 380mg IM injection is offered 4 weeks later (monthly).
Motivational Enhancement Counseling Only
n=17 participants at risk
The randomized control arm receives no medication treatment and is offered brief, two-session Motivational Enhancement counseling prior to release from jail. Motivational Enhancement Counseling: The randomized control arm receives no medication treatment and is offered brief, two-session Motivational Enhancement counseling prior to release from jail.
General disorders
Anticipated XR-NTX Symptoms
25.0%
4/16 • Number of events 4 • Adverse Events collected during 8 weeks post-release.
0.00%
0/17 • Adverse Events collected during 8 weeks post-release.
Injury, poisoning and procedural complications
Shoulder Seperation
6.2%
1/16 • Number of events 1 • Adverse Events collected during 8 weeks post-release.
0.00%
0/17 • Adverse Events collected during 8 weeks post-release.
Respiratory, thoracic and mediastinal disorders
Respiratory Problems
0.00%
0/16 • Adverse Events collected during 8 weeks post-release.
5.9%
1/17 • Number of events 1 • Adverse Events collected during 8 weeks post-release.

Additional Information

Joshua D. Lee

NYU School of Medicine

Phone: 212-263-4242

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place