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Long-term opioid therapy among patients with systemic lupus erythematosus in the community. A Lupus Midwest Network study
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4 2023
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Source: J Rheumatol. 50(4):504-511
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Details:
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Alternative Title:J Rheumatol
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Personal Author:
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Description:Objective
There is little information about the epidemiology and factors associated with opioid therapy in systemic lupus erythematosus (SLE). We aimed to assess the prevalence of opioid therapy and explore factors associated with long-term opioid therapy (LTOT) in patients with SLE.
Methods
Patients with SLE were matched with non-SLE controls in a population-based cohort on January 1, 2015. We captured demographics, manifestations of lupus, comorbidities (fibromyalgia, mood disorders, osteoarthritis, chronic low back pain [CLBP], chronic kidney disease, avascular necrosis, osteoporosis, fragility fractures, and cancer), and the area deprivation index (ADI). Opioid prescription data were used to assess prevalence of LTOT, defined as contiguous prescriptions (gaps of <30 days between prescriptions) and receiving opioid therapy ≥90 days or ≥10 prescriptions before index date.
Results
465 SLE patients and 465 non-SLE controls were included; 13% of SLE patients and 3% of non-SLE controls were receiving opioid therapy (P<0.001), and 11% of SLE patients were on LTOT versus 1% of non-SLE controls. Among SLE patients, acute pericarditis (OR: 3.92; 95% CI: 1.78–8.66), fibromyalgia (OR: 7.78; 95% CI: 3.89–15.55), fragility fractures (OR: 3.72; 95% CI: 1.25–11.07), CLBP (OR: 4.00; 95% CI: 2.13–7.51), and mood disorders (OR: 2.76; 95% CI: 1.47–5.16) were associated with LTOT. We did not find an association between opioid therapy and ADI.
Conclusion
Patients with SLE have higher LTOT than controls. Among patients with SLE, LTOT was associated with pericarditis and several comorbidities. However, LTOT was not associated with kidney disease despite the limited pain control options in these patients.
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Pubmed ID:36379579
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Pubmed Central ID:PMC10066823
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Funding:
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Volume:50
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Issue:4
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