Clinical Edge Journal Scan

Opioids not safer than NSAID in patients with RA


 

Key clinical point: Opioids not only increase the risk for all-cause mortality among patients with rheumatoid arthritis (RA) but also carry a similar risk for major adverse cardiovascular events (MACE) as nonsteroidal anti-inflammatory drugs (NSAID).

Major finding: The risk for MACE was similar among patients initiating opioids and those initiating NSAID (adjusted hazard ratio [aHR] 1.02; 95% CI 0.85-1.22); however, opioid initiators had a 33% higher risk for all-cause mortality compared with NSAID initiators (aHR 1.33; 95% CI 1.06-1.67).

Study details: This new user active comparator cohort study included patients with RA within the FORWARD databank and propensity-score matched patients initiating opioids (n = 6866) to those initiating NSAID (n = 13,689).

Disclosures: This study was supported by the Rheumatology Research Foundation Resident Preceptor Award. The authors declared no conflicts of interest.

Source: Ozen G et al. Major adverse cardiovascular events and mortality with opioids versus NSAIDs initiation in patients with rheumatoid arthritis. Ann Rheum Dis. 2023 (Jul 17). doi: 10.1136/ard-2023-224339

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