DMARD Use in RA May Lead to Decreased Risk of Long-Term Opioid Use
A poster presentation at ACR Convergence 2021 compared risk factors for long-term opioid use among DMARD and non-DMARD users.
Treatment with disease-modifying antirheumatic drugs (DMARDs) may lower the risk of long-term opioid use in patients with rheumatoid arthritis (RA), according to a recent study presented during ACR Convergence 2021, the annual meeting of the American College of Rheumatology.1
Investigators used the national Medicare database to perform a cross-sectional study between 2017 and 2018 that analyzed long-term opioid use in patients with RA who received at least 1 30-day opioid prescription. The risk of long-term opioid use was compared between DMARD- and non-DMARD users. The cohort was further divided based on DMARD regimen, set forth by the ACR, for treatment of RA.
Investigators identified 27,028 patients with RA who received at least a 30-day opioid prescription. The mean age of the cohort was 69.7 years; participants were 80% women, and 76.8% White; 11.7% were Black and 7.8% were Hispanic. Approximately 70% of patients were currently using DMARD therapy.
Long-term opioid use was lower among DMARD users compared to non-DMARD users: 37% and 43%, respectively. While risk factors for long-term opioid use—including depression, anxiety, bipolar disorder, drug use, and opioid use disorder—were prevalent in both DMARD and non-DMARD users, these factors occurred more often in non-DMARD users.
The following depicts the findings for risk factors rates for long-term opioid use in non-DMARD and DMARD users, respectively:
- Anxiety – 42.8% vs 31.9%
- Depression – 43.6% vs 36.6%
- Previous drug abuse – 18.6% vs 12.2%
- Previous opioid use disorder – 17% vs 11%
“DMARD use in [patients with RA] was associated with decreased risk of long-term opioid use,” the researchers concluded. “These agents represent a possible opportunity to lower the risk of long-term opioid use in an especially vulnerable population. Appropriate use of DMARDs in [patients with RA] may result in decreased dependence on opioids for chronic pain.”
Reference
- Sood A, Kuo Y, Westra J, et al. DMARD use in Medicare patients with rheumatoid arthritis and risk of long-term opioid use. Presented at: ACR Convergence 2021; November 3-9, 2021. Abstract 0587.
