Opioid Use in Rheumatic Disease Declined After 2014

TOPLINE:

Since 2014, opioid use for autoimmune rheumatic decreased by 15% annually while other management modalities increased or stabilized.

METHODOLOGY:

• Researchers analyzed de-identified US claims data from the MarketScan Database from 2007-2021.
• The study included nearly 142,000 patients with autoimmune rheumatic diseases: 10,927 with ankylosing spondylitis (AS); 21,438 with psoriatic arthritis (PsA); 71,393 with rheumatoid arthritis (RA); 16,718 with Sjögren disease; 18,018 with systemic lupus erythematosus; and 3468 with systemic sclerosis.
• Primary outcome was opioid use annual trends, with secondary outcomes including trends in the use of anticonvulsants, antidepressants, skeletal muscle relaxants, nonsteroidal anti-inflammatory drugs (NSAIDs), topical pain medications, and physical or occupational therapy.

TAKEAWAY:

• The incidence of opioid use increased annually by 4% until 2014 and decreased annually by 15% after 2014.
• NSAID use increased 2% annually until 2014, then declined by 5% afterward.
• The proportion of patients utilizing physical therapy or anticonvulsants doubled from 2008 to 2020.
• NSAID prescriptions were highest in AS, PsA, and RA, while they were lowest in Sjögren disease and systemic sclerosis.

IN PRACTICE:

“Our work, along with the published literature, highlights the need for future studies to evaluate the effectiveness of pain management modality changes over time and to understand the possible effects that changes have had on outcomes such as quality of life, disability, health status, and function,” wrote the authors of the study. 

SOURCE:

The study was led by Titilola Falasinnu, PhD, Stanford University School of Medicine, Stanford, California. It was published online on June 27, 2024, in The Lancet Rheumatology. 

LIMITATIONS:

The study relied on administrative claims data, which did not contain information on use of over-the-counter medications like NSAIDs and topical analgesics. The study did not include the duration of pain treatment modalities, making it difficult to differentiate between acute and chronic use. The analysis did not include race or ethnicity, which is important for understanding pain outcomes across different sociodemographic groups.

DISCLOSURES:

The study was supported by grants from the National Institute of Arthritis and Musculoskeletal and Skin Diseases. 

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.