for the main comparison.
| Antagonist‐induced compared to conventional for opioid withdrawal | ||||||
|
Patient or population: patients with opioid withdrawal Settings: Intervention: Antagonist‐induced Comparison: conventional | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| conventional | Antagonist‐induced | |||||
| Number completing detoxification | Medium risk population | RR 1.42 (1.09 to 1.84) | 100 (2) | ⊕⊕⊝⊝ low1,2 | ||
| 576 per 1000 | 818 per 1000 (628 to 1060) | |||||
| Number commencing naltrexone maintenance treatment ‐ Clonidine comparison | Medium risk population | RR 4.28 (2.91 to 6.3) | 240 (3) | ⊕⊕⊕⊝ moderate2 | ||
| 177 per 1000 | 758 per 1000 (515 to 1115) | |||||
| Number commencing naltrexone maintenance treatment ‐ Buprenorphine comparison | Medium risk population | RR 1.29 (1.04 to 1.6) | 72 (1) | ⊕⊕⊕⊝ moderate2 | ||
| 730 per 1000 | 942 per 1000 (759 to 1168) | |||||
| Retained in naltrexone maintenance treatment or abstinent at 12 weeks ‐ Tapered methadone comparison | Medium risk population | RR 2 (0.9 to 4.45) | 30 (1) | ⊕⊕⊝⊝ low1,2 | ||
| 333 per 1000 | 666 per 1000 (300 to 1482) | |||||
| Retained in naltrexone maintenance treatment or abstinent at 12 weeks ‐ Clonidine comparison | Medium risk population | RR 2.77 (1.37 to 5.61) | 240 (3) | ⊕⊕⊕⊝ moderate2 | ||
| 88 per 1000 | 244 per 1000 (121 to 494) | |||||
| Retained in naltrexone maintenance treatment or abstinent at 12 weeks ‐ Buprenorphine comparison | Medium risk population | RR 0.82 (0.34 to 1.97) | 72 (1) | ⊕⊕⊕⊝ moderate2 | ||
| 243 per 1000 | 199 per 1000 (83 to 479) | |||||
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RR: Risk ratio; | ||||||
| GRADE Working Group grades of evidance High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. | ||||||
1 One study at high risk of allocation bias.
2 Less than 300 events