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Patients with gout are more likely than those without to initiate chronic opioid use, according to study results presented at the American College of Rheumatology (ACR) 2023 Annual Meeting, held from November 10 to 15, in San Diego, California.
Gout flares can be extremely painful, often leading individuals to seek medical attention and resort to opioid therapy for relief. Consequently, there are concerns that the use of opioids for gout flares may lead to chronic opioid use. Considering this, researchers conducted a matched cohort study to compare the risk of initiating chronic opioid use among Veteran’s Health Administration (VHA) patients with vs without gout. They also aimed to identify determining factors associated with initiation.
Patients with gout had a significantly higher chance of initiating chronic opioid use compared against those without gout (adjusted hazard ratio [aHR], 1.36; 95% CI, 1.34-1.39).
Among patients with gout, those who identified as Black, had comorbidities, received urate-lowering treatment, and had a rheumatology encounter were more likely to use chronic opioids.
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Associations between patient characteristics and time-to-initiating chronic opioid use highlight potential gaps in care, particularly among underserved Black/African American and rural populations as well as the potential for adequate urate control to reduce the risk of chronic opioid use in gout.
Men, patients with chronic kidney disease, those residing in an urban area, patients with satisfactory serum urate control, those of older age, and those who identified as Asian, Native Hawaiian/Pacific Islander, or American Indian were less likely to use chronic opioids.
Study authors concluded, “In the VHA, we found that patients with gout were 36% more likely than those without gout to initiate chronic opioid use, after accounting for potential confounders, despite opioids not being recommended for management of gout flares.”
“Associations between patient characteristics and time-to-initiating chronic opioid use highlight potential gaps in care, particularly among underserved Black/African American and rural populations as well as the potential for adequate urate control to reduce the risk of chronic opioid use in gout,” they noted.
Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.
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