PHILADELPHIA— The National Institutes of Health’s Helping to End Addiction Long-term (HEAL) initiative chose the Penn Presbyterian Medical Center as one of its sites for a study comparing the effectiveness of two different methods for emergency departments to initiate opioid use recovery medication. The study will begin in September and be led by Jeanmarie Perrone, MD, professor of Emergency Medicine and director of the Center for Addiction Medicine and Policy.
The NIDA Clinical Trials Network’s New England Consortium Node with investigators at Yale University are tapped to lead the overall study, but approximately 30 different sites received funding as part of the NIH’s $945 million initiative. The study being undertaken by Penn Medicine and several other sites is being called the Emergency Department-Initiated Buprenorphine Validation Network Trial (ED-INNOVATION). It focuses on the prescription of buprenorphine, a drug that mitigates patients’ cravings for opioids, which helps to prevent overdose. Because of those properties, buprenorphine can be initiated in the emergency department to begin treatment immediately and “bridge” the gap of time until a patient receives outpatient follow-up recovery care.
The NIH has enlisted the ED-INNOVATION sites like Penn Presbyterian to compare two different methods for administering buprenorphine: a pill form taken under the tongue and an extended release injection with effects that last for seven days. Over 18 months, this arm of the NIH study is expected to enroll roughly 2,000 patients. Perrone will be joined by Emergency Medicine faculty member co-Investigators David Jang, MD, Anish Agarwal, MD, Sean Foster, MD, and Zachary Meisel, MD.
"I have already witnessed the power of this new treatment strategy through our own program to stabilize a patient with opioid use for the first week to allow them a glimpse of recovery,” Perrone said. “This allows for them to be more prepared mentally and physically when they meet their follow-up provider to continue in treatment."
Penn Medicine established the Center for Opioid Recovery and Engagement (CORE) in 2018. Perrone serves as medical director. It is a program designed to help identify and offer recovery help to individuals who are treated in Penn Medicine emergency departments. It grew in success as a part of the Innovation Accelerator in the Penn Medicine Center for Health Care Innovation last year, and one of the main focuses was getting more doctors trained and comfortable with writing “bridge prescriptions” of buprenorphine to patients. Patients with opioid use disorder who participate in the program have had great success, with numbers indicating that seven out of 10 patients who received buprenorphine were still engaged a month in to treatment. National numbers for those without buprenorphine hover around just one in 10.
The 7-day injection form of buprenorphine is a new formulation. Because the CORE program has only used the under-the-tongue(sublingual) or tablet form of buprenorphine, the new study will introduce a time-released injection to patients.
“This is an opportunity to expand the treatment options we have available for our patients,” Perrone said. “With more methods available to deliver this medication, I believe the path to recovery will become more accessible for many more people.”
Penn Medicine is one of the world’s leading academic medical centers, dedicated to the related missions of medical education, biomedical research, and excellence in patient care. Penn Medicine consists of the Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania (founded in 1765 as the nation’s first medical school) and the University of Pennsylvania Health System, which together form a $8.9 billion enterprise.
The Perelman School of Medicine has been ranked among the top medical schools in the United States for more than 20 years, according to U.S. News & World Report's survey of research-oriented medical schools. The School is consistently among the nation's top recipients of funding from the National Institutes of Health, with $496 million awarded in the 2020 fiscal year.
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