- Rheumatic diseases have high rates of long-term (≥90 days) prescription opioid use, with ankylosing spondylitis (AS) leading the way and systemic lupus erythematosus (SLE) having the lowest likelihood compared with hypertension, the nonpainful control condition.
Why this matters
- This is the first large study of long-term opioid use in rheumatic diseases.
- Findings will help target strategies to reduce opioid use.
- Analysis of prescription claims from the Truven MarketScan, a US commercial claims database, 2003-2014, for long-term opioid use (during 1-year of follow-up) in rheumatoid arthritis (RA; n=181,710), AS (n=7686), SLE (n=45,834), and psoriatic arthritis (PsA; n=30,307).
- Relative risks (RRs) of long-term opioid use were calculated vs hypertension (n=265,537; matched by age and sex).
- Funding: Brigham and Women's Hospital; Harvard Medical School.
- Rates of long-term prescription opioid use:
- AS, 25%.
- RA, 19%.
- SLE, 16%.
- PsA, 15%.
- Hypertension, 5%-6%.
- The RR (highest to lowest) of receiving long-term opioid prescriptions in each rheumatic disease vs hypertension in multivariate analysis:
- AS (RR, 2.73; 95% CI, 2.60-2.87).
- RA (RR, 2.21; 95% CI, 2.16-2.25).
- PsA (RR, 1.94; 95% CI, 1.87-2.00).
- SLE (RR, 1.82; 95% CI, 1.77-1.88).
- Lack of information about disease severity, pain, and other patient characteristics.
- Analysis ended in 2014, which may not be generalizable to 2019.