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Opioid use in patients with rheumatoid arthritis 2005–2014: a population-based comparative study

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Abstract

Opioid prescriptions have seen an increase across the USA, Canada, Europe, and the UK. In the USA, they have quadrupled from 1999 to 2010. Opioid use among patients with rheumatoid arthritis (RA) over time is not well described. This study examined trends of opioid use in patients with RA. Retrospective prescription data was examined from 2005 to 2014 in a population-based incidence cohort of patients with RA by 1987 ACR criteria and comparable non-RA subjects. Differences in opioid use were examined with Poisson models. A total of 501 patients with RA (71 % female) and 532 non-RA subjects (70 % female) were included in the study. Total and chronic opioid use in 2014 was substantial in both cohorts 40 % RA vs 24 % non-RA and 12 % RA vs. 4 % non-RA, respectively. Opioid use increased by 19 % per year in both cohorts during the study period (95 % confidence interval [CI] 1.15, 1.25). Relative risk (RR) of chronic opiate use for RA patients compared to non-RA subjects was highest in adults aged 50–64 years (RR 2.82; 95 % CI 1.43–6.23). RA disease characteristics, biologic use at index, treated depression/fibromyalgia, education, and smoking status were not significantly associated with chronic opiate use. Over a third of patients with RA use opioids in some form, and in more than a tenth use is chronic. Use has increased in recent years. Patients aged 50–64 with RA use substantially more opioids than their non-RA counterparts.

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Acknowledgments

Grants/financial supports: This study was funded by a grant from the National Institutes of Health NIAMS (R01 AR46849) and made possible using the resources of the Rochester Epidemiology Project, which is supported by the National Institute on Aging of the National Institutes of Health under Award Number R01AG034676 and CTSA grant number UL1 TR000135 from the National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health (NIH). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Authors and Affiliations

  1. Division of Rheumatology, Mayo Clinic College of Medicine, Rochester, MN, USA

    Jorge A. Zamora-Legoff, Cynthia S. Crowson, Megan L. Krause, John M. Davis III & Eric L. Matteson

  2. Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, MN, USA

    Sara J. Achenbach & Cynthia S. Crowson

  3. Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, USA

    Eric L. Matteson

Authors
  1. Jorge A. Zamora-Legoff
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  2. Sara J. Achenbach
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  3. Cynthia S. Crowson
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  4. Megan L. Krause
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  5. John M. Davis III
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  6. Eric L. Matteson
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Corresponding author

Correspondence to Eric L. Matteson.

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This historic cohort study was approved by the Mayo Clinic and Olmsted Medical Center Institutional Review Boards.

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Zamora-Legoff, J.A., Achenbach, S.J., Crowson, C.S. et al. Opioid use in patients with rheumatoid arthritis 2005–2014: a population-based comparative study. Clin Rheumatol 35, 1137–1144 (2016). https://doi.org/10.1007/s10067-016-3239-4

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  • DOI: https://doi.org/10.1007/s10067-016-3239-4

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