PT  - JOURNAL ARTICLE
AU  - Victor S.  Sloan
AU  - Anna Sheahan
AU  - Jeffrey L.  Stark
AU  - Robert Y.  Suruki
TI  - Opioid Use in Patients with Ankylosing Spondylitis is Common in the United States: Outcomes of a Retrospective Cohort Study
AID  - 10.3899/jrheum.180972
DP  - 2019 Jan 15
TA  - The Journal of Rheumatology
PG  - jrheum.180972
4099  - http://www.jrheum.org/content/early/2019/01/15/jrheum.180972.short
4100  - http://www.jrheum.org/content/early/2019/01/15/jrheum.180972.full
AB  - 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.