Evidence map›Paper›PMID 40660643›Full record

SynthesisDrug and alcohol dependence2025

Extended-release naltrexone versus oral naltrexone for substance use disorders: A systematic review and meta-analysis.

Ahmed Elmosalamy, Akanksha Sirohi, Amr Moustafa, Omar Masoud, Leslie C Hassett, Bhanu P Kolla, Balwinder Singh

Abstract readSystematic ReviewMeta-AnalysisComparative Study
In one paragraph

Synthesis in Drug and alcohol dependence, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Guideline
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Ahmed ElmosalamyDepartment of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA.
Akanksha SirohiDepartment of Internal Medicine, Anne Arundel Medical Center, Annapolis, MD, USA.
Amr MoustafaDepartment of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA.
Omar MasoudRoyal Free London NHS Foundation Trust, United Kingdom.
Leslie C HassettMayo Clinic Libraries, Rochester, MN, USA.
Bhanu P KollaDepartment of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA.
Balwinder SinghDepartment of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA. Electronic address: singh.balwinder@mayo.edu.

Funding

Institutional Career Development CoreKL2TR002379 · NCATS · MAYO CLINIC ROCHESTER · PI NILUFER ERTEKIN-TANER · 2017 to 2026
$14.9M
NCATS NIH HHS KL2 TR002379
6 · The paper itself

Abstract

purposeThis systematic review and meta-analysis aimed to compare extended-release naltrexone (XR-NTX) and oral naltrexone (NTX) for treating substance use disorders (SUDs).

methodsA comprehensive search of multiple databases (MEDLINE, Embase, Cochrane, APA PsycInfo, and Scopus) was conducted on October 1, 2024, with no date or language restrictions. Inclusion criteria were adults with SUDs, interventions with XR-NTX, comparisons with oral NTX, and outcomes on treatment persistence, hospitalizations, and emergency department (ED) visits. Randomized controlled trials (RCTs) and observational studies were included. Odds ratios were calculated using the Mantel-Haenszel random-effects model.

resultsOf the 1116 studies screened, 27 were selected for full-text review, 15 met the inclusion criteria (3 open-label RCTs [n = 340] and 12 retrospective studies [n = 18,695]) focusing on alcohol use disorder (AUD) and opioid use disorder (OUD), and 7 were included in the meta-analysis. We found no other SUD where the two interventions were compared. Treatment persistence was significantly higher with XR-NTX compared to oral NTX at both 3 months (OR 1.43 [95 % CI: 1.04-1.96], p = 0.03) and 6 months (OR 1.96 [95 % CI: 1.37-2.81], p = 0.0002). No significant differences were observed in healthcare utilization, including inpatient admissions (OR 0.69 [95 % CI: 0.30-1.61], p = 0.39) or ED visits (OR 1.17 [95 % CI: 0.61-2.26], p = 0.63).

conclusionsPatients with AUD and OUD receiving XR-NTX stay in treatment longer than those receiving oral NTX. However, hospitalization and ED visit rates did not differ. Findings are limited due to a small number of RCTs.

Indexed as

NaltrexoneNarcotic AntagonistsSubstance-Related DisordersAdministration, OralDelayed-Action PreparationsHumansOpioid-Related DisordersRandomized Controlled Trials as TopicDelayed-Action PreparationsNaltrexoneNarcotic AntagonistsAlcohol use disorderExtended-release injectable naltrexoneNaltrexoneOpioid use disorderOral naltrexone

Identifiers

PMID40660643
PMCPMC12289340

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.