Long-Term Opioid Therapy Among Patients With Systemic Lupus Erythematosus in the Community: A Lupus Midwest Network (LUMEN) Study

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. Patients with SLE were ma...

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Published in:Journal of rheumatology 2023-04, Vol.50 (4), p.504-511
Main Authors: Figueroa-Parra, Gabriel, Jeffery, Molly M, Dabit, Jesse Y, Chevet, Baptiste, Valenzuela-Almada, Maria O, Hocaoglu, Mehmet, Osei-Onomah, Shirley-Ann, Kurani, Shaheen, Vallejo, Sebastian, Achenbach, Sara J, Hooten, W Michael, Barbour, Kamil E, Crowson, Cynthia S, Duarte-García, Alí
Format: Article
Language:English
Subjects:
Analgesics, Opioid - therapeutic use
Fibromyalgia - drug therapy
Fibromyalgia - epidemiology
Fractures, Bone
Humans
Lupus Erythematosus, Systemic - complications
Lupus Erythematosus, Systemic - drug therapy
Lupus Erythematosus, Systemic - epidemiology
Pericarditis
Retrospective Studies
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Summary: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. Patients with SLE were matched with controls without SLE in a population-based cohort on January 1, 2015. We captured demographics, manifestations of SLE, comorbidities (ie, fibromyalgia, mood disorders, osteoarthritis, chronic low back pain [CLBP], chronic kidney disease (CKD), avascular necrosis, osteoporosis, fragility fractures, and cancer), and the Area Deprivation Index (ADI). Opioid prescription data were used to assess the prevalence of LTOT, defined as contiguous prescriptions (gaps of < 30 days between prescriptions) and receiving opioid therapy for ≥ 90 days or ≥ 10 prescriptions before the index date. A total of 465 patients with SLE and 465 controls without SLE were included. In total, 13% of patients with SLE and 3% of controls without SLE were receiving opioid therapy ( < 0.001), and 11% of patients with SLE were on LTOT vs 1% of controls without SLE. Among patients with SLE, acute pericarditis (odds ratio [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. Patients with SLE are more likely to receive LTOT than controls. Among patients with SLE, LTOT was associated with pericarditis and several comorbidities. However, LTOT was not associated with CKD despite the limited pain control options among these patients.
ISSN:0315-162X
1499-2752
DOI:10.3899/JRHEUM.220822