Opioid use frequency in early axial spondyloarthritis in Finland - a pharmacoepidemic register study.

Autor: Muilu P; Department of Internal Medicine, Centre for Rheumatic Diseases, Tampere University Hospital, Tampere, Finland. Electronic address: paula.muilu@pshp.fi., Rantalaiho V; Department of Internal Medicine, Centre for Rheumatic Diseases, Tampere University Hospital, Tampere, Finland; Department of Internal Medicine, Kanta-Hame Central Hospital, Hameenlinna, Finland; Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland., Kautiainen H; Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland; Folkhälsan Research Center, Helsinki, Finland., Virta LJ; Research Department, Social Insurance Institution of Finland, Turku, Finland., Puolakka K; Terveystalo Healthcare, Lappeenranta, Finland.
Jazyk: angličtina
Zdroj: Joint bone spine [Joint Bone Spine] 2022 May; Vol. 89 (3), pp. 105302. Date of Electronic Publication: 2021 Oct 20.
DOI: 10.1016/j.jbspin.2021.105302
Abstrakt: Objectives: To evaluate opioid use among incident axial spondyloarthritis (axSpA) patients compared to general population.
Methods: From the national register, we identified all adult patients with axSpA (ICD-10 codes M45-46), who between 2010 and 2014 (index date, ID) were for the first time granted special reimbursement for any disease-modifying antirheumatic drugs (DMARDs). Three matched population controls were identified for each patient. Drug purchases were evaluated between 2009-2015, and opioid use was analyzed for one year before and after the ID. The Defined Daily Dose (DDD) was used as a tool to assess the opioid consumption before and after the biological (b) DMARD initiation.
Results: We identified 3577 axSpA patients and 10,573 controls. Of these patients, 97.2% started a conventional synthetic (cs) DMARD during a year after ID and 23.4% switched later to a self-injected bDMARD between the ID and 31 Dec 2015 (median follow-up 3.4 years). Opioids were purchased at least once by 29.8% and 21.7% of the patients in the years before and after the ID, respectively, compared to 8.1% and 7.8% of the controls. The proportion of opioid-using patients was greatest during the last quarter before the ID [relative risk (RR) 4.72 (95% CI 4.14 to 5.39)] compared to controls, and it remained higher [RR 2.84 (2.59 to 3.11)] also after the start of csDMARDs. DDD of opioid consumption decreased from 7.7 to 1.6/1000 inhabitants after bDMARD initiation.
Conclusion: Considerably more axSpA patients than population controls used opioids. The opioid consumption by dose decreased clearly after bDMARD initiation.
(Copyright © 2021. Published by Elsevier Masson SAS.)
Databáze: MEDLINE
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