RT Journal Article
T1 Efficacy of prescribed injectable diacetylmorphine in the Andalusian trial: Bayesian analysis of responders and non-responders according to a multi domain outcome index.
A1 Perea-Milla, Emilio
A1 Silva Ayçaguer, Luis Carlos
A1 March Cerdà, Joan Carles
A1 González Saiz, Francisco
A1 Rivas-Ruiz, Francisco
A1 Danet, Alina
A1 Romero Vallecillo, Manuel
A1 Oviedo-Joekes, Eugenia
K1 Administración oral
K1 Teorema de bayes
K1 Heroína
K1 dependencia de heroína
K1 Inyecciones
K1 Metadona
K1 Narcoticos
K1 Andalucía
K1 Resultado del tratamiento
AB BACKGROUNDThe objective of this research was to evaluate data from a randomized clinical trial that tested injectable diacetylmorphine (DAM) and oral methadone (MMT) for substitution treatment, using a multi-domain dichotomous index, with a Bayesian approach.METHODSSixty two long-term, socially-excluded heroin injectors, not benefiting from available treatments were randomized to receive either DAM or MMT for 9 months in Granada, Spain. Completers were 44 and data at the end of the study period was obtained for 50. Participants were determined to be responders or non responders using a multi-domain outcome index accounting for their physical and mental health and psychosocial integration, used in a previous trial. Data was analyzed with Bayesian methods, using information from a similar study conducted in The Netherlands to select a priori distributions. On adding the data from the present study to update the a priori information, the distribution of the difference in response rates were obtained and used to build credibility intervals and relevant probability computations.RESULTSIn the experimental group (n = 27), the rate of responders to treatment was 70.4% (95% CI 53.287.6), and in the control group (n = 23), it was 34.8% (95% CI 15.354.3). The probability of success in the experimental group using the a posteriori distributions was higher after a proper sensitivity analysis. Almost the whole distribution of the rates difference (the one for diacetylmorphine minus methadone) was located to the right of the zero, indicating the superiority of the experimental treatment.CONCLUSIONThe present analysis suggests a clinical superiority of injectable diacetylmorphine compared to oral methadone in the treatment of severely affected heroin injectors not benefiting sufficiently from the available treatments.TRIAL REGISTRATION Current Controlled Trials ISRCTN52023186.
PB BioMed Central
YR 2009
FD 2009-08-14
LK http://hdl.handle.net/10668/1991
UL http://hdl.handle.net/10668/1991
LA en
NO Perea-Milla E, Silva Ayçaguer LC, March Cerdà JC, González Saiz FG, Rivas-Ruiz F, Danet A, et al. Efficacy of prescribed injectable diacetylmorphine in the Andalusian trial: Bayesian analysis of responders and non-responders according to a multi domain outcome index. Trials.  2009; 10:70
NO Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't;
DS RISalud
RD Apr 10, 2025