PMID- 38019160
OWN - NLM
STAT- MEDLINE
DCOM- 20240329
LR  - 20240331
IS  - 0392-856X (Print)
IS  - 0392-856X (Linking)
VI  - 42
IP  - 3
DP  - 2024 Mar
TI  - Do subjective components of disease activity contribute to heterogeneity in 
      opioid prescriptions in inflammatory rheumatic diseases? Results from ESPOIR and 
      DESIR cohorts.
PG  - 671-681
LID - 10.55563/clinexprheumatol/nq59pt [doi]
AB  - OBJECTIVES: To determine whether subjective components of disease activity are 
      associated with heterogeneity in opioid prescription in inflammatory rheumatic 
      diseases (IRDs) after accounting for objective inflammatory markers. METHODS: 
      Data from two prospective observational cohorts of early IRDs (ESPOIR for 
      rheumatoid arthritis (RA) and DESIR for spondyloarthritis (SpA)) were included. 
      Opioid prescription duration (converted to monthly binary opioid prescription), 
      disease activity (Disease activity score 28 (DAS28) for RA; Axial 
      spondyloarthritis disease activity score-C-reactive protein (ASDAS-CRP) for SpA) 
      and its components were measured respectively at 13 and 9 occasions spanning 10- 
      and 6-years of follow-up. Group-based trajectory modelling defined 
      opioid-prescription trajectories and mixed-models characterised the evolution of 
      disease activity and its subjective components by opioid-prescription 
      trajectories. RESULTS: Four distinct opioid-prescription trajectories: no/low 
      (60.5% and 54.3%), declining (14.7% and 15.8%), augmenting (11.9% and 10.7%), and 
      persistent (12.9% and 19.1%) were identified in RA and SpA respectively (60% were 
      prescribed opioids at least once). Those with regular opioid prescriptions (up to 
      30%) are often older, less educated, have higher BMI and worse disease. No/low 
      trajectory was the reference for examining evolution of disease activity and 
      subjective components (n=810 RA, n=679 SpA). In IRDs, consistently higher disease 
      activity throughout follow-up were seen with persistent (DAS28(beta=0.4-0.8); 
      ASDAS-CRP(beta=0.4-0.6)), and augmenting (DAS28(beta=0.2-0.5); ASDAS-CRP(beta=0.3-0.6)) 
      trajectories and until 3- or 4-years of follow-up (DAS28(beta=0.3-0.4); 
      ASDAS-CRP(beta=0.2-0.3)) with declining trajectory. Likewise, despite accounting for 
      objective inflammation, subjective components had worse scores over follow-up in 
      augmenting and persistent trajectory. CONCLUSIONS: Non-inflammatory pain 
      mechanisms amplify subjective outcomes, thus, worsening composite measures like 
      disease activity.
FAU - Kumaradev, Sushmithadev
AU  - Kumaradev S
AD  - Clinical Epidemiology Applied to Rheumatic and Musculoskeletal Diseases, 
      Universite Paris Cite, Inserm U1153, Paris; and Epidemiology of Ageing and 
      Neurodegenerative Diseases, Universite Paris Cite, Inserm U1153, Paris, France. 
      sushmithadev.kumaradev@inserm.fr.
FAU - Roux, Christian
AU  - Roux C
AD  - Clinical Epidemiology Applied to Rheumatic and Musculoskeletal Diseases, 
      Universite Paris Cite, Inserm U1153, Paris; and Department of Rheumatology, 
      APHP-Centre, Cochin Hospital, Paris, France.
FAU - Sellam, Jeremie
AU  - Sellam J
AD  - Department of Rheumatology, APHP, Sorbonne Universite, Inserm UMRS_938, 
      Saint-Antoine Hospital, Paris, France.
FAU - Perrot, Serge
AU  - Perrot S
AD  - Pain Clinic, APHP-Centre, INSERM U897, Cochin Hospital, Paris, France.
FAU - Pham, Thao
AU  - Pham T
AD  - Department of Rheumatology, APHM, Sainte-Marguerite Hospital, Aix-Marseille 
      University, Marseille, France.
FAU - Molto, Anna
AU  - Molto A
AD  - Clinical Epidemiology Applied to Rheumatic and Musculoskeletal Diseases, 
      Universite Paris Cite, Inserm U1153, Paris; and Department of Rheumatology, 
      APHP-Centre, Cochin Hospital, Paris, France.
FAU - Dugravot, Aline
AU  - Dugravot A
AD  - Epidemiology of Ageing and Neurodegenerative Diseases, Universite Paris Cite, 
      Inserm U1153, Paris, France.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20231129
PL  - Italy
TA  - Clin Exp Rheumatol
JT  - Clinical and experimental rheumatology
JID - 8308521
RN  - 0 (Analgesics, Opioid)
SB  - IM
MH  - Humans
MH  - Analgesics, Opioid/therapeutic use
MH  - *Arthritis, Rheumatoid/diagnosis/drug therapy
MH  - Inflammation/drug therapy
MH  - Prescriptions
MH  - *Rheumatic Fever
MH  - Severity of Illness Index
MH  - *Spondylarthritis/diagnosis/drug therapy
MH  - Prospective Studies
EDAT- 2023/11/29 12:43
MHDA- 2024/03/29 06:45
CRDT- 2023/11/29 10:13
PHST- 2023/06/01 00:00 [received]
PHST- 2023/09/18 00:00 [accepted]
PHST- 2024/03/29 06:45 [medline]
PHST- 2023/11/29 12:43 [pubmed]
PHST- 2023/11/29 10:13 [entrez]
AID - 20017 [pii]
AID - 10.55563/clinexprheumatol/nq59pt [doi]
PST - ppublish
SO  - Clin Exp Rheumatol. 2024 Mar;42(3):671-681. doi: 
      10.55563/clinexprheumatol/nq59pt. Epub 2023 Nov 29.