From 2002 to 2015, chronic opioid use doubled among patients with rheumatoid arthritis (RA), according to results published in Arthritis & Rheumatology.

The results indicated that severe pain and antidepressant use were the strongest predictors of chronic opioid use.

The study included participants with RA from the Corrona registry. The researchers measured opioid use using surveys conducted at clinical visits, as often as every 3 months. They defined chronic opioid use as any opioid use reported during ≥2 consecutive study visits.

The researchers calculated annual prevalence of chronic opioid use among participants with RA for whom data were available on opioid use from ≥2 clinic visits (n=33,739). Researchers used Cox proportional hazards model to identify associations between patient characteristics and incident chronic opioid use among participants not taking opioids at baseline (n=26,288).

From 2002 to 2015, chronic opioid use increased from 7.4% to 16.9%. The researchers identified severe pain (hazard ratio [HR], 2.53; 95% CI, 2.19-2.91), antidepressant use (HR, 1.79; 95% CI, 1.64-1.92), high disease activity (HR, 1.55; 95% CI, 1.30-1.84), and high disability (HR, 1.45; 95% CI, 1.26-1.65) as being associated with an increased risk for chronic opioid use. They also found that Asian race was associated with a decreased risk for chronic opioid use (HR, 0.49; 95% CI, 0.36-0.68).

“These data highlight the importance of: a) treating inflammatory disease activity aggressively with a treat-to-target strategy, and b) evaluating and treating pain and mental health problems before prescribing opioid medications and in addition to treating with [disease-modifying antirheumatic drugs],” the researchers wrote.

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Several authors reported financial ties to the pharmaceutical industry. Please see original source for a full list of disclosures.

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Reference

Lee YC, Kremer J, Guan H, Greenberg J, Solomon DH. Chronic opioid use in rheumatoid arthritis: prevalence and predictors [published online November 26, 2018]. Arthritis Rheumatol. doi:10.1002/art.40789