Osteoarthritis, NSAID Allergy Are Risk Factors for Opioid Use Disorder

medication, pills
medication, pills
Researchers assessed whether patients with osteoarthritis and NSAID allergies have higher odds of developing opioid use disorder, and identified next steps to be considered for this patient population.

Patients with osteoarthritis and nonsteroidal anti-inflammatory drug (NSAID) allergies have a higher risk of developing opioid use disorder (OUD), according to research presented at the American College of Asthma, Allergy & Immunology (ACAAI) 2020 Annual Scientific Meeting, held virtually from November 13 to November 15, 2020.

Investigators conducted a retrospective cohort study of 15,682 adult patients with osteoarthritis receiving care between January 2013 and December 2018. In total, 1442 patients (9.2%) reported a NSAID allergy.

After adjusting for baseline characteristics and comorbidities, a propensity score matched analysis showed that patients with reported NSAID allergy has significantly higher odds of developing OUD compared with patients without NSAID allergies (odds ratio [OR], 1.53; 95% CI, 1.03-2.25; P =.03). This patient population also had higher odds of a documented opioid prescription in their electronic medical records (OR, 1.23; 95% CI, 1.05-1.46; P =.01). Other risk factors for OUD in patients with osteoarthritis and reported NSAID allergy included younger age, male sex, being recipients of Medicare, Medicaid, or dual insurance; and having comorbid depression.

In patients with osteoarthritis and reported NSAID allergies, a “referral to an allergy specialist should be considered for drug allergy evaluation with potential drug challenge and allergy de-labeling,” the study authors concluded.


Li L, Chang Y, Song S, Losina E, Costenbader K, Laidlaw T. Clinical impact of reported non-steroidal anti-inflammatory drug allergies in patients with osteoarthritis. Presented at: the American College of Allergy, Asthma & Immunology (ACAAI) 2020 Annual Scientific Meeting (Virtual Experience); November 13-15, 2020. Abstract A003.

This article originally appeared on Pulmonology Advisor