Opioids tied to higher risk of infections in rheumatoid arthritis

(HealthDay)—The use of opioid analgesics may increase the risk of serious infection in patients with rheumatoid arthritis (RA), according to research published in the February issue of Arthritis & Rheumatology.

Andrew D. Wiese, M.D., of the Vanderbilt University Medical Center in Nashville, Tenn., and colleagues conducted a self-controlled case series analysis of data for a retrospective cohort of 13,796 patients with RA who were enrolled in Tennessee Medicaid from 1995 to 2009. Within-person comparisons were performed to examine risk of hospitalization for serious infection during periods of opioid use and non-use.

The researchers found that among 1,790 patients with RA who had one or more hospitalizations for serious infection, the adjusted incidence rate of serious infection was higher for periods of current opioid use versus non-use (incidence rate ratio [IRR], 1.39; 95 percent confidence interval [CI], 1.19 to 1.62). Compared with periods of non-use, higher incidence rates were found during periods of long-acting opioid use (IRR, 2.01; 95 percent CI, 1.52 to 2.66), immunosuppressive opioid use (IRR, 1.72; 95 percent CI, 1.33 to 2.23), and new opioid use (IRR, 2.38; 95 percent CI, 1.65 to 3.42).

"In within-person comparisons of patients with RA, opioid use was associated with an increased risk of hospitalization for serious infection," the authors write.

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