Arthritis Rheumatol:慢性阿片类药物在类风湿性关节炎中的应用

2018-12-06 xiangting MedSci原创

疼痛和使用抗抑郁药是慢性阿片类药物使用的最强预测因子。

阿片类药物流行是一个重大的公共卫生问题。然而,目前关于类风湿性关节炎(RA)患者中阿片类药物的使用知之甚少。这项研究探讨了2002-2015年RA患者中慢性阿片类药物的使用趋势,并确定了临床预测因子。

从Corrona登记确定RA患者。通过每3个月一次的临床访视调查确定阿片类药物的使用。使用慢性阿片类药物被定义为≥2次的连续研究访视期间使用任何阿片类药物。在≥2次访视中有阿片类药物使用数据的3373名RA患者中计算慢性阿片类药物使用的年患病率。在基线未使用阿片类药物的26288名个体中,使用Cox比例风险模型确定患者特征与慢性阿片类药物使用之间的相关性。

慢性阿片类药物使用率从2002年的7.4%升高至2015年的16.9%。严重疼痛(HR 2.53,95%CI 2.19-2.92)和使用抗抑郁药物(HR 1.79,95%CI 1.64-1.92)与使用慢性阿片类药物的风险升高相关。疾病活动性高(HR 1.55,95%CI 1.30-1.84)和残疾程度高(HR 1.45,95%CI 1.27-1.65)也与使用慢性阿片类药物相关,而亚裔(HR 0.49,95%CI 0.36-0.68)与使用慢性阿片类药物的风险降低相关。

在RA患者中,2002年至2015年慢性阿片类药物的使用率翻番。疼痛和使用抗抑郁药是慢性阿片类药物使用的最强预测因子。为了遏制慢性阿片类药物使用的增多,严格控制RA疾病活动性以及管理疼痛和抑郁症的策略应当成为研究重点。

原始出处:

Yvonne C. Lee. Chronic Opioid Use in Rheumatoid Arthritis: Prevalence and Predictors. Arthritis Rheumatol. 26 November 2018.

本文系梅斯医学(MedSci)原创编译整理,转载需授权!

 

 

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    2018-12-08 lmm397
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    2018-12-08 lhlxtx
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    2018-12-08 zhaojie88
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