Study Finds Comorbidity, Opioid Use Are High Among Inflammatory Arthritis Patients

The burden of comorbidities is high, and the use of opioid medications is “remarkable” among patients with inflammatory rheumatic diseases, according to a recent study conducted in Belgium.

The researchers sought to compare the 3-year comorbidity incidence and use of prescribed pain medication among patients diagnosed with rheumatoid arthritis (RA), psoriatic arthritis (PsA), or spondyloarthritis (SpA) versus controls.

Using data from the years 1999 through 2012 gathered from morbidity registry of general practitioners in Flanders, Belgium, the team identified 738, 229, and 167 patients with a diagnosis of RA, SpA or PsA, respectively, based on case codes. These cases were further verified to validate the diagnosis of RA, SpA, or PsA.  The investigators matched these patients to controls according to age, gender, general practice, and diagnosis date, and analyzed the 3-year comorbidity burden in cases and controls, using the Rheumatic Diseases Comorbidity Index (RDCI).

“Patients with RA or PsA had comparable median RDCI scores at baseline, but higher scores at year 3 compared with controls (RA: p=0.010; PsA: p=0.008),” the authors wrote. “At baseline, depression was more prevalent in PsA patients vs controls (p<0.003). RA patients had a higher 3-year incidence of cardiovascular disease including myocardial infarction than controls (p<0.035).”

Noting that patients in all 3 disease categories “were given more prescriptions than controls for any pain medication type, even opioids excluding tramadol,” the researchers stated that “high opioid use in all populations was remarkable.”

They concluded, “This study highlights the increasing comorbidity burden of patients with chronic inflammatory rheumatic conditions, especially for individuals with RA or PsA.”

--Rebecca Mashaw

Reference:

Stouten V, Pazmino S, Verschueren P.Comorbidity burden in the first three years after diagnosis in patients with rheumatoid arthritis, psoriatic arthritis or spondyloarthritis: a general practice registry-based study. RMD Open. Published online July 15, 2021. DOI: https://dx.doi.org/10.1136/rmdopen-2021-001671