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Opioid Use among Patients with Early Inflammatory Arthritides Compared to the General Population.

Authors
  • Muilu, Paula1, 2
  • Rantalaiho, Vappu3, 4
  • Kautiainen, Hannu3, 4
  • Virta, Lauri Juhani3, 4
  • Puolakka, Kari3, 4
  • 1 From the Department of Medicine, Tampere University Hospital; Centre for Rheumatic Diseases, Tampere University Hospital; Faculty on Medicine and Health Technology, Tampere University, Tampere; Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital; Primary Health Care Unit, Kuopio University Hospital, and Folkhälsan Research Centre, Helsinki; Unit of Primary Health Care, Turku University Hospital; Research Department, Social Insurance Institution of Finland, Turku; Department of Medicine, South Karelia Central Hospital, Lappeenranta, Finland. [email protected] [email protected] , (Finland)
  • 2 P. Muilu, MD, Medical Specialist in Internal Medicine in the Department of Internal Medicine, Centre for Rheumatic Diseases, Tampere University Hospital; V. Rantalaiho, MD, PhD, Docent, Specialist in Rheumatology in the Department of Internal Medicine, Centre for Rheumatic Diseases, Tampere University Hospital and Faculty on Medicine and Health Technology, Tampere University; H. Kautiainen, Biostatistician, Primary Health Care Unit, Kuopio University Hospital, and Folkhälsan Research Centre; L.J. Virta, MD, PhD, Docent, Research Department, Social Insurance Institution of Finland; K. Puolakka, MD, PhD, Docent, Specialist in Rheumatology, Chief of Division, Department of Internal Medicine, Centre for Rheumatic Diseases, South Karelia Central Hospital. [email protected] [email protected] , (Finland)
  • 3 From the Department of Medicine, Tampere University Hospital; Centre for Rheumatic Diseases, Tampere University Hospital; Faculty on Medicine and Health Technology, Tampere University, Tampere; Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital; Primary Health Care Unit, Kuopio University Hospital, and Folkhälsan Research Centre, Helsinki; Unit of Primary Health Care, Turku University Hospital; Research Department, Social Insurance Institution of Finland, Turku; Department of Medicine, South Karelia Central Hospital, Lappeenranta, Finland. , (Finland)
  • 4 P. Muilu, MD, Medical Specialist in Internal Medicine in the Department of Internal Medicine, Centre for Rheumatic Diseases, Tampere University Hospital; V. Rantalaiho, MD, PhD, Docent, Specialist in Rheumatology in the Department of Internal Medicine, Centre for Rheumatic Diseases, Tampere University Hospital and Faculty on Medicine and Health Technology, Tampere University; H. Kautiainen, Biostatistician, Primary Health Care Unit, Kuopio University Hospital, and Folkhälsan Research Centre; L.J. Virta, MD, PhD, Docent, Research Department, Social Insurance Institution of Finland; K. Puolakka, MD, PhD, Docent, Specialist in Rheumatology, Chief of Division, Department of Internal Medicine, Centre for Rheumatic Diseases, South Karelia Central Hospital. , (Finland)
Type
Published Article
Journal
The Journal of Rheumatology
Publisher
The Journal of Rheumatology
Publication Date
Aug 01, 2020
Volume
47
Issue
8
Pages
1285–1292
Identifiers
DOI: 10.3899/jrheum.190355
PMID: 31615910
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

To assess to what extent the worldwide opioid epidemic affects Finnish patients with early inflammatory arthritis (IA). From the nationwide register maintained by the Social Insurance Institution of Finland, we collected all incident adult patients with newly onset seropositive and seronegative rheumatoid arthritis (RA+ and RA-) and undifferentiated arthritis (UA) between 2010 and 2014. For each case, 3 general population (GP) controls were matched according to age, sex, and place of residence. Drug purchases between 2009 and 2015 were evaluated 1 year before and after the index date (date of IA diagnosis), further dividing this time into 3-month periods. A total of 12,115 patients (66% women) were identified. At least 1 opioid purchase was done by 23-27% of the patients 1 year before and 15-20% one year after the index date. Relative risk (RR) of opioid purchases compared to GP was highest during the last 3-month time period before the index date [RR 2.81 (95% CI 2.55-3.09), 3.06 (2.68-3.49), and 4.04 (3.51-4.65) for RA+, RA-, and UA, respectively] but decreased after the index date [RR 1.38 (1.23-1.58), 1.91 (1.63-2.24), and 2.51 (2.15-2.93)]. Up to 4% of the patients were longterm users both before and after the diagnosis. During 2009-15 in Finland, opioid use peaked just before the diagnosis of IA but decreased rapidly after that, suggesting effective disease control, especially in seropositive RA. Further, opioids were used to treat arthritis pain of patients with incident RA and UA less often than previously reported from other countries.

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