Abstract
Objective To assess the prevalence of chronic opioid use in patients with ankylosing spondylitis (AS), and compare the characteristics of patients with and without chronic opioid use.
Methods This was a retrospective cohort study of AS patients identified in the Truven MarketScan® database between 01-Jan-2012 and 31-Mar-2017. Commercial and Medicaid claims data were examined using both specific (720.0 and M45.x) and broader (720.x and M45.x) diagnostic coding definitions. Patients were aged ≥18 years on the date of first qualifying ICD code occurrence (the index date). Demographics and clinical characteristics were assessed in the 12-month period preceding the index date. The 12-month follow-up period was used to assess prevalence and characteristics of chronic opioid use.
Results Chronic opioid use was common among patients with commercial claims (23.5% of 720.0 patients; 27.3% of 720.x patients), and especially those with Medicaid claims (57.1% and 76.7%, respectively). The proportion of patients with claims for anti-TNFs during follow-up was often low, and for Medicaid patients was lower among those with chronic opioid use (29.6% of 720.0 patients; 2.3% of 720.x patients) than those without (47.1% and 7.1%, respectively). Among chronic opioid users in all cohorts, the cumulative supply of opioids was typically high (≥270 days in the follow-up period); most opioids prescribed were Schedule II.
Conclusion AS patients receive opioids with concerning frequency. The infrequent prescription of recommended therapies to these patients reflects a need to optimize treatment further through education of patients and healthcare professionals alike.