Transition to Long-Term Opioid Use High in Patients With Rheumatic Disease

TUESDAY, May 23, 2023 (HealthDay News) -- For patients living with rheumatic and musculoskeletal diseases (RMD), the proportion of those initiating opioids for the first time who transition to long-term use is high, according to a research letter published online May 16 in the Annals of the Rheumatic Diseases.

Yun-Ting Huang, Ph.D., from the University of Manchester in the United Kingdom, and colleagues examined the proportion of patients with one of six RMD conditions newly initiated on an opioid who transitioned to long-term use. Participants included 841,047 adults with a diagnosis of rheumatoid arthritis (RA), psoriatic arthritis (PsA), axial spondyloarthritis (AxSpA), systemic lupus erythematosus (SLE), osteoarthritis (OA), and fibromyalgia (12,260; 5,195; 3,046; 3,081; 796, 276; and 21,189, respectively), without prior cancer. Long-term opioid users were defined using the standard, stringent, and broad definitions.

The researchers found that 1,081,216 new episodes of opioid use were identified among all patients, of whom 16.8, 11.1, and 21.9 percent transitioned to long-term use using the standard, stringent, and broad definitions, respectively. Among the six RMDs, patients with fibromyalgia made up the highest proportion of long-term opioid users (27.4, 20.9, and 33.7 for standard, stringent, and broad definitions, respectively), followed by RA (25.7, 18.5, and 32.3 percent, respectively) and AxSpA (23.8, 17.3, and 29.6 percent, respectively). OA patients made up the lowest proportion of long-term opioid users (16.4, 10.7, and 21.4 percent, respectively).

"Introduction of prompt interventions, such as medication reviews or deprescribing, to ensure the appropriateness of long-term opioid therapy, and proactive consideration of nonpharmacological treatments for pain relief would also be of benefit to reduce avoidable harms in this patient population," the authors write.

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