Paediatric Rheumatology
Opioid use in children with inflammatory bowel disease-related arthritis
A.O. Bilgic Dagci1, J.C. Chang2, R. Xiao3, A.B. Grossman4, P.F. Weiss5
- Division of Rheumatology, Children’s Hospital of Philadelphia, PA, and Division of Pediatric Rheumatology, University of Michigan, Ann Arbor, MI, USA. olcaybilgicdagci@gmail.com
- Division of Immunology, Boston Children’s Hospital and Harvard Medical School, Boston, MA, and Division of Rheumatology, Department of Pediatrics, Center for Pediatric Clinical Effectiveness, University of Pennsylvania Perelman School of Medicine and Children’s Hospital of Philadelphia, PA, USA.
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
- Division of Gastroenterology, Hepatology, and Nutrition, Children’s Hospital of Philadelphia, PA, USA.
- Division of Rheumatology, Department of Pediatrics, Center for Pediatric Clinical Effectiveness, University of Pennsylvania Perelman School of Medicine and Children’s Hospital of Philadelphia, PA, USA.
CER16369
2023 Vol.41, N°7
PI 1553, PF 1560
Paediatric Rheumatology
PMID: 37083174 [PubMed]
Received: 10/11/2022
Accepted : 27/01/2023
In Press: 06/04/2023
Published: 10/07/2023
Abstract
OBJECTIVES:
Concomitant arthritis may increase risk of chronic opioid use in youngsters with IBD. We aimed to assess trends and clinical features associated with opioid use in children with IBD-related arthritis.
METHODS:
Adolescents under 18 years of age with IBD-related arthritis, at least 1 year of continuous enrolment, and at least 1 pharmacy claim in the Truven Health MarketScan Claims and Encounter Database were included. Subjects were identified using previously validated algorithms consisting of ICD codes, pharmacy claims and procedure codes. The primary outcome was chronic opioid exposure. Temporal trends in opioid exposure were tested using the Cuzick-Wilcoxon test. The association of chronic opioid use and baseline covariates in the IBD and IBD-arthritis cohorts were examined using multivariable logistic regression models.
RESULTS:
14,943 adolescents with IBD, 480 of whom had arthritis, were included. Chronic opioid use was non-trivial in youngsters with IBD-related arthritis, higher than that of total IBD cohort (12.3% vs. 5%) and remained stable over the years of study. Using multivariable regression, joint pain and arthritis were significantly associated with chronic opioid exposure in young people with IBD. Among IBD-related arthritis patients older age, public insurance, gastrointestinal surgery, hospitalisation and psychiatric comorbidities were significantly associated with chronic opioid use.
CONCLUSIONS:
Chronic opioid use in adolescents with IBD-related arthritis was higher than that of total IBD cohort but stable over the years of study. Future study is needed to explore ways to optimise non-narcotic pain management strategies and ensuring appropriate use of opioids when necessary.
