In the Journals

Patients with hidradenitis suppurativa at higher risk for long-term opioid use

Patients with hidradenitis suppurativa had a 53% increased risk for long-term opioid use compared with a control population, according to researchers in JAMA Dermatology.

Using EHR data, the researchers identified 22,277 adult patients with hidradenitis suppurativa (HS) and 828,832 control subjects. Mean age of patients with HS was 40.8 years; 75.9% of patients were women, 59.2% were white, and 33% were black.

The overall crude 1-year incidence of long-term opioid use among opioid-naive patients with HS was 0.33% (74 of 22,277 patients) compared with 0.14% of control subjects (1,168 of 828,832).

Patients with HS had 1.53 times the odds of incident long-term opioid use compared with controls, according to the researchers’ fully adjusted model (95% CI, 1.20-1.95).

Patients with HS who reported tobacco smoking at one time had a 3.64 times increased risk for long-term opioid use compared with patients with HS who never smoked. Additionally, patients with HS and depression had almost twice the odds of long-term opioid use compared with those without depression (OR = 1.97; 95% CI, 1.21-3.19).

Most patients (74.3%) with long-term opioid use received a prescription with oxycodone hydrochloride; hydrocodone bitartrate was the second most often prescribed at 59.5%.

“[T]he chronic nociceptive nature of pain in HS may be at least as likely to prompt patients to pursue and sustain opioid therapy as may the pain in inflammatory and mechanical arthritis or perioperatively,” Lauren A.V. Orenstein, MD, of the department of dermatology at Emory University School of Medicine, Atlanta, and colleagues wrote. “As such, our results suggest that similar monitoring may be warranted for patients with HS, particularly if other risk factors, such as smoking and depression, are present.” – by Abigail Sutton

 

Disclosures: Orenstein reports she receives personal fees from Frontline Medical Communications and MedEd Consulting. Please see the study for all other authors’ relevant financial disclosures.

Patients with hidradenitis suppurativa had a 53% increased risk for long-term opioid use compared with a control population, according to researchers in JAMA Dermatology.

Using EHR data, the researchers identified 22,277 adult patients with hidradenitis suppurativa (HS) and 828,832 control subjects. Mean age of patients with HS was 40.8 years; 75.9% of patients were women, 59.2% were white, and 33% were black.

The overall crude 1-year incidence of long-term opioid use among opioid-naive patients with HS was 0.33% (74 of 22,277 patients) compared with 0.14% of control subjects (1,168 of 828,832).

Patients with HS had 1.53 times the odds of incident long-term opioid use compared with controls, according to the researchers’ fully adjusted model (95% CI, 1.20-1.95).

Patients with HS who reported tobacco smoking at one time had a 3.64 times increased risk for long-term opioid use compared with patients with HS who never smoked. Additionally, patients with HS and depression had almost twice the odds of long-term opioid use compared with those without depression (OR = 1.97; 95% CI, 1.21-3.19).

Most patients (74.3%) with long-term opioid use received a prescription with oxycodone hydrochloride; hydrocodone bitartrate was the second most often prescribed at 59.5%.

“[T]he chronic nociceptive nature of pain in HS may be at least as likely to prompt patients to pursue and sustain opioid therapy as may the pain in inflammatory and mechanical arthritis or perioperatively,” Lauren A.V. Orenstein, MD, of the department of dermatology at Emory University School of Medicine, Atlanta, and colleagues wrote. “As such, our results suggest that similar monitoring may be warranted for patients with HS, particularly if other risk factors, such as smoking and depression, are present.” – by Abigail Sutton

 

Disclosures: Orenstein reports she receives personal fees from Frontline Medical Communications and MedEd Consulting. Please see the study for all other authors’ relevant financial disclosures.