Baher Mankabady, MD, highlights safety of buprenorphine against OUD in pregnancy

In a recent interview with Contemporary OB/GYN, Baher Mankabady, MD, Senior Vice President at Indivior, discussed a study finding safety and efficacy from the use of buprenorphine (SUBLOCADE; Indivior Inc) to treat opioid use disorder (OUD) during pregnancy.

Mankabady highlighted the severe public health threat posed by OUD in pregnant patient. As a partial opioid agonist, buprenorphine can improve health outcomes such as preterm birth and low birth weight risks. Mankabady recommended reflecting medical guidelines to support buprenorphine use.

Contemporary OB/GYN:

How does OUD threaten maternal and infant health?

Baher Mankabady, MD:

So opioid use during pregnancy is a serious and growing public health concern. As we all know, it increased the risk of preterm birth, low birth weight, maternal complication, and for mothers, it increases the risk of relapse, overdose, and infection. A couple of steps. I want to just let you know is substance use disorder is now the leading cause of death in the US, and it tripled since 2007.

Contemporary OB/GYN:

How can buprenorphine improve health outcomes?

Mankabady:

Buprenorphine is a partial opioid agonist. The safety profile of buprenorphine has been established for over 20 years, and it's an efficacious treatment for OUD. What happened with this study is the largest known database study for long acting, injectable SUBLOCADE is not only that buprenorphine is safe and efficacious, but also improves adherence, reduce rediversion, misuse, abuse and persistent therapeutic range for patients.

Contemporary OB/GYN:

What is the significance of these findings?

Mankabady:

As I mentioned earlier, this is the largest known database study for use of SUBLOCADE during pregnancy, almost 5 years’ worth of data. This finding suggests that SUBLOCADE is not only an efficacious treatment, but it's a safe treatment, and it's a great option for patients dealing with opioid use disorder while their pregnant.

Contemporary OB/GYN:

What steps must be taken to expand OUD treatment?

Mankabady:

That is a good question. I’ll start with 3 things. First, eliminate the stigma and misinformation that discouraged providers or health care providers from treating pregnant individuals with OUD. Second, update medical guidelines to reflect the use of SUBLOCADE formulation or long-acting formulation in treatment guidelines. Last but not least, expand access to medication assisted treatment, especially in OB-GYN and primary care settings.

Contemporary OB/GYN:

Is there anything you would like to add?

Mankabady:

What I want to mention is pregnancy is a unique, motivating time. When patients with OUD, when they get pregnant, this is the time that they will be open for treatment and engagement with health care providers. This study offers promising evidence that SUBLOCADE can be safely considered during treatment of OUD during pregnancy.

Reference

Krishnapura SR, McNeer E, Loch SF, et al. Buprenorphine treatment in pregnancy and maternal-infant outcomes. JAMA Health Forum. 2025;6(4.11):e251814. doi:10.1001/jamahealthforum.2025.1814