Opioid Use Among RA Patients Has Declined, But Remains High

Opioid use has declined slightly among patients with rheumatoid arthritis (RA), but 40% still receive regular opioid prescriptions, according to the findings of a recent study.

For their study, the researchers used Medicare data from 2006 to 2014 to identify 70,929 patients with RA, of whom 83.8% were female, 12.1% were black, 80.2% were white, and the mean age was 67.4 years. Regular opioid use was defined as more than 3 prescriptions filled in each 12-month interval. In 2014, a separate analysis was conducted to assess opioid prescribing patterns among rheumatologists.
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Hydrocodone and propoxyphene were the most commonly prescribed opioids, and regular opioid receipt increased slowly and peaked in 2010. The withdrawal of propoxyphene resulted in a decrease in opioid prescriptions, but overall opioid use only declined slightly. Prescriptions for hydrocodone and tramadol increased following the withdrawal of propoxyphene.

Overall, 40% of patients with RA used prescribed opioids regularly, and regular opioid use was associated with younger age, female sex, black race, back pain, fibromyalgia, anxiety, and depression.

In addition, the secondary analysis showed that variability between rheumatologists in prescription of regular opioids was high. Almost half of RA patients had at least some opioid prescriptions written by a rheumatologist, and 14% of patients had been co-prescribed the same opioids by 1 or more physician. 

“In the US, opioid use peaked in older RA patients in 2010 and is now declining slightly,” the researchers concluded. “Withdrawal of propoxyphene from the U.S. market in 2010 had minimal effect on overall use, as it was replaced with greater use of other opioids.”

—Melissa Weiss

Reference:

Curtis JR, Xie F, Smith C, et al. Changing trends in opioid use among US rheumatoid arthritis patients [published online June 21, 2017]. Arthritis Rheum. doi:10.1002/art.40152.