Opioids Associated With Fracture Risks Among Older Patients With AS

Older age, historical fracture, and opioid use were associated with higher odds of fracture in Medicare beneficiaries with ankylosing spondylitis, according to study results published online ahead of print in Arthritis Care & Research.

The retrospective cohort study linked data from the Rheumatology Informatics System for Effectiveness (RISE) registry to Medicare claims from 2016 to 2018 to identify 1426 adults with prevalent ankylosing spondylitis. Their mean age was 69.4 years, 44.3% were female, and 77.3% were non-Hispanic White.

Among the 1426 patients with ankylosing spondylitis, 197 experienced fractures. The overall incidence rate of fractures was 76.7 per 1000 person-years, according to the study.

Odds ratios for fracture were 5.24 with historical fracture, 2.8 with older age, and 1.86 with use of more than 30 mg of morphine equivalent, the study found. The likelihood of fracture was equal between men and women.

“Because opioid use was associated with fracture in ankylosing spondylitis, this high-risk population should be considered for interventions to mitigate risk,” advised corresponding author Rachael Stovall, MD, MAS, of the University of California San Francisco Division of Rheumatology, San Francisco, California, and study coauthors.

Reference
Stovall R, Kersey E, Li J, et al. Incidence rate and factors associated with fractures among Medicare beneficiaries with ankylosing spondylitis in the United States. Arthritis Care Res. Published online August 22, 2023. doi:10.1002/acr.25219