Opioid Use Associated With Fractures in People With Ankylosing Spondylitis

Increasing age, historical fracture, and opioid use are associated with higher odds of fracture in ankylosing spondylitis (AS), according to a study published in Arthritis Care & Research.

“We performed a retrospective cohort study with data from the Rheumatology Informatics System for Effectiveness registry linked to Medicare claims from 2016 to 2018,” wrote corresponding author Rachael Stovall, University of California in San Francisco, CA, and coauthors.

The study's main objective was to assess the incidence rate of fracture and the associated factors among adults with AS. The study included a total of 1426 adults with AS with a mean age of 69.4 years. 44.3% were women and 77.3% were non-Hispanic White. Among them, 197 adults with AS experienced fractures. The overall incidence rate was 76.7 (95% confidence interval [CI] 66.4–88.6) per 1000 person-years. The study concluded that older age (odds ratio [OR] 2.8, 95% CI 1.39–5.65), historical fracture (OR 5.24, 95% CI 3.44–7.99), and use of more than 30 mg morphine equivalent (OR 1.86, 95% CI 1.08–3.19) were associated with higher odds of fractures among adults with AS.

“In this large sample of Medicare beneficiaries with AS, increasing age, historical fracture, and use of opioids had higher odds of fracture,” concluded the study authors. “Because opioid use was associated with fracture in AS, this high-risk population should be considered for interventions to mitigate risk,” they added.

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 (Hoboken). Published online August 22, 2023. doi:10.1002/acr.25219