Chronic Opioid Use in Ankylosing Spondylitis Is ‘Concerning’

Patients with ankylosing spondylitis (AS) are being prescribed opioids at a “concerning” rate, according to the researchers of a new study.

To reach this conclusion, the researchers identified participants from the Truven MarketScan database from between January 1, 2012, and March 31, 2017. The participants all had AS and were aged 18 years or older on the date of the first qualifying ICD code occurrence.

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The researchers examined both commercial and Medicaid claims data using specific (720.0 and M45.x) and broader (720.x and M45.x) diagnostic coding definitions.

While demographics and clinical characteristics were assessed in the year-long period prior to the index date, the prevalence and chronic opioid use characteristics were assessed in the year-long follow-up time.

Results indicated that chronic opioid use was common among participants with commercial claims (23.5% of 720.0 participants, 27.3% of 720.x participants). However, chronic opioid use was even more common among those with Medicaid claims.

Among individuals in the Medicaid group, 57.1% of participants with the 720.0 diagnostic code and 76.7% of those with the 720.x code had chronically taken opioids.

Among all participants who had taken opioids chronically, the cumulative supply of opioids was typically high (≥270 days in the follow-up period), with the most commonly prescribed type being Schedule II.

The number of patients with claims for anti-tumor necrosis factor during follow-up was low, especially among participants with Medicaid who had chronic opioid use (29.6% of 720.0 participants, 2.3% of 720.x participants) when compared with the rates of those with Medicaid who were not chronically taking opioids (47.1% and 7.1%, respectively).

“The infrequent prescription of recommended therapies to these patients reflects a need to optimize treatment further through education of patients and healthcare professionals alike,” the researchers concluded.

—Colleen Murphy

Reference:

Sloan VS, Sheahan A, Stark JL, Suruki RY. Opioid use in patients with ankylosing spondylitis is common in the United States: outcomes of a retrospective cohort study. [published online January 15, 2019]. J Rheumatol. https://doi.org/10.3899/jrheum.180972.