• Andrew J Saxon, Walter Ling, Maureen Hillhouse, Christie Thomas, Albert Hasson, Alfonso Ang, Geetha Doraimani, Gudaye Tasissa, Yuliya Lokhnygina, Jeff Leimberger, R Douglas Bruce, John McCarthy, Katharina Wiest, Paul McLaughlin, Richard Bilangi, Allan Cohen, George Woody, and Petra Jacobs.
• Veteran's Affairs Puget Sound Health Care System, 1660 South Columbian Way, Room 116 ATC, Seattle, WA 98108, USA.
• Drug Alcohol Depend. 2013 Feb 1; 128 (1-2): 71-6.

BackgroundBuprenorphine/naloxone (BUP) and methadone (MET) are efficacious treatments for opioid dependence, although concerns about a link between BUP and drug-induced hepatitis have been raised. This study compares the effects of BUP and MET on liver health in opioid-dependent participants.MethodsThis was a randomized controlled trial of 1269 opioid-dependent participants seeking treatment at 8 federally licensed opioid treatment programs and followed for up to 32 weeks between May 2006 and August 2010; 731 participants met "evaluable" criteria defined as completing 24 weeks of medication and providing at least 4 blood samples for transaminase testing. Participants were randomly assigned to receive BUP or MET for 24 weeks. Shift table analysis determined how many evaluable participants moved between categories of low and elevated transaminase levels. Predictors of moving from low to high transaminase levels were identified.ResultsChanges in transaminase levels did not differ by medication condition. Baseline infection with hepatitis C or B was the only significant predictor of moving from low to elevated transaminase levels; 9 BUP and 15 MET participants showed extreme liver test elevations and were more likely than those without extreme elevations to have seroconverted to both hepatitis B and C during the study, or to use illicit drugs during the first 8 weeks of treatment. MET participants were retained longer in treatment than BUP participants.ConclusionsThis study demonstrated no evidence of liver damage during the initial 6 months of treatment in either condition. Physicians can prescribe either medication without major concern for liver injury.Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

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