Annual trends in pain management modalities in patients with newly diagnosed autoimmune rheumatic diseases in the USA from 2007 to 2021: an administrative claims-based study
Authors' conclusion
Since 2014, the use of non-opioid pain management modalities has increased or stabilised, whereas opioid and NSAID use has declined.
Study context
- Population
- Newly diagnosed AS, PsA, RA, Sjögren's syndrome, SSc or SLE in the Merative Marketscan Research Databases (US employment-sponsored insurance claims), 2007–2021107,475 (75.7%) women
- Participants
- 141,962 participants
- Exposure
- Annual trends by calendar year, before vs after 2014
- ASn = 10,927
- PsAn = 21,438
- RAn = 71,393
- Sjögren's syndromen = 16,718
- SLEn = 18,018
- SScn = 3,468
- Outcome
- Annual incidence of patients treated with opioids, anticonvulsants, antidepressants, skeletal muscle relaxants, non-steroidal anti-inflammatory drugs (NSAIDs), topical analgesics and physical therapy
- Follow-up
- Year following diagnosis
Methodological detailsadministrative claims-based, logistic regression adjusted for age, sex and region
- Administrative claims-based
- Logistic regression adjusted for age, sex and region
Main finding
As reported in the abstract
Annual change in incidence of pain management modality use, by calendar year
- Opioid use, annual change until 2014
- aOR 1.04 (1.03-1.04) (95% CI)
- Opioid use, annual change after 2014
- aOR 0.85 (0.84-0.86) (95% CI)
- Physical therapy use, annual change until 2014
- aOR 1.05 (1.04-1.06) (95% CI)
- Physical therapy use, annual change after 2014
- aOR 0.99 (0.98-1.00) (95% CI)
- Anticonvulsant use, annual change until 2014
- aOR 1.07 (1.07-1.08) (95% CI)
- Anticonvulsant use, annual change after 2014, not significant
- aOR 1.00 (0.99-1.00) (95% CI)
- NSAID use, annual change before 2014
- aOR 1.02 (1.02-1.03) (95% CI)
- NSAID use, annual change after 2014
- aOR 0.95 (0.95-0.96) (95% CI)
Observational data: associations, not effects.
Further findings
- Trends did not differ by sex except NSAID use before 2014
- P for interaction = 0.02
- Topical analgesic use after 2014 differed by sex
- P for interaction = 0.0100
Original publication
Annual trends in pain management modalities in patients with newly diagnosed autoimmune rheumatic diseases in the USA from 2007 to 2021: an administrative claims-based study. Lancet Rheumatol. Published 27 June 2024. doi:10.
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