Nonmedical Use of Xtampza® ER and Other Oxycodone Medications in Adults Evaluated for Substance Abuse Treatment: Real-World Data from the Addiction Severity Index-Multimedia Version (ASI-MV®)

Abstract

Purpose The purpose of this study was to evaluate real-world data related to past 30-day nonmedical use (NMU) and routes of administration of Xtampza ® ER and comparator oxycodone medications in the US as captured within the Addiction Severity Index-Multimedia Version ® (ASI-MV ® ). Methods Data were collected from July 2016 through December 2019 from 647 centers located in 44 states using the ASI-MV, a clinical instrument used to evaluate substance use and treatment planning. Demographic characteristics were assessed using Pearson’s chi-square test for categorical data and quarterly NMU rates were calculated. Distribution of route of administration was studied using a proportional reporting ratio (PRR) analysis. Results Of 192,810 assessments, 42,279 (21.9%) indicated past 30-day NMU of at least one prescription opioid, including Xtampza ER (N=73, 0.2%), other oxycodone ER (n=3802, 9.0%) and oxycodone IR (n=14,579, 34.5%). All quarterly Xtampza ER NMU rates per 100 ASI-MV assessments were significantly lower than those for other oxycodone ER and oxycodone IR. Overall, quarterly Xtampza ER NMU drug utilization adjusted rates were significantly lower than quarterly rates observed for other oxycodone ER NMU but not consistently significantly lower than oxycodone IR NMU. Although not all statistically significant, all ratios from the PRR analysis were less than 1.0, indicating that rates of use of any alternate route, any non-oral route, snorting, and injecting were higher for other oxycodone ER and oxycodone IR than for Xtampza ER. Conclusion Xtampza ER had significantly lower rates of NMU than other oxycodone ER products and oxycodone IR products, as well as significantly lower rates of non-oral NMU than oxycodone IR products, in a population of individuals seeking substance abuse treatment. Understanding risks associated with different opioid medications is important for prescribers as they manage risks of opioid misuse and abuse with effective pain therapy.

A US Retrospective Claims Analysis Comparing Healthcare Costs of Patients Transitioning from Immediate-Release Oxycodone to Two Different Formulations of Extended-Release Oxycodone: Xtampza ER or OxyContin

“…Further, Xtampza ER had lower rates of non-oral manipulation, including insufflation and injection, than did the other ER ADF oxycodone group. 11 …”

“…The large national studies demonstrated differences in misuse, abuse, and diversion rates among ADF ER opioids. 11 , 12 Still, the economic implications of these findings have not been further elaborated. There is also a lack of studies directly comparing different formulations of the same medication, and this may be the most accurate way to measure the impact of ADF formulations.…”

Review of Opioid Abuse-Deterrent Formulations: Impact and Barriers to Access

“… Green JL et al J Pain Res . 2021 59 Rates of nonmedical use (deviation from legitimate medical use) of Xtampza ER were lower than other oxycodone ER (eg, OxyContin) and IR products. Severtson SG et al Pain Med .…”

“…An analysis of the Addiction Severity Index-Multimedia Version found that Xtampza ER had significantly lower rates of nonmedical use and nonoral nonmedical use than OxyContin and non-ADF oxycodone IR products in individuals seeking substance abuse treatment. 59 A study evaluating the RADARS system found low rates of abuse/misuse (composite endpoint of cases by combining 3 exposure categories: intentional abuse, intentional misuse, and intentional unknown exposures as defined in the annual report of the National Poison Data System) and diversion of Xtampza ER compared with other prescription opioid analgesics. 60 Moreover, abuse and misuse did not increase for 3 years (July 1, 2016, through June 30, 2019) after initial marketing of Xtampza ER into the US market.…”