Best of 2024: Analgesic Prescribing in Patients with Inflammatory Arthritis Save

Editor's note: this article originally appeared October 7, 2024 and is being shared again as a Best of 2024. Enjoy!

A UK cross-sectional EHR clinical practice analysis between 2004 and 2020 shows that analgesic prescribing in inflammatory arthritis (IA) patients has declined, but still remains substantial, including opioid prescribing. 

Data was drawn from the Clinical Practice Research Datalink Aurum to evaluate analgesic prescription annual prevalence in patients with RA, PsA and axial spondyloarthritis (axSpA) and found that analgesic prescribing declined over time but remained common:

• 2004 IA prescriptions  - 84.2/100 person-years (PY)
  • In 2004, NSAIDs were most prescribed (56.1/100 PY; 55.8, 56.5), and dropped over time 
• 2020 IA prescriptions - 64.5/100 PY . 
  • In 2020, Opioids were most prescribed (39.0/100 PY). Most opioid prescriptions were chronic (23.4/100 PY). 
• Gabapentinoid prescribing increased from 1.1/100 PY to 9.9/100 PY between 2004 and 2020.
• Non-NSAID analgesic was common in RA, older people, females and deprived areas/northern England. 
• NSAID use was more common in axSpA/males
• Prognostic factors for chronic opioid/gabapentinoid and NSAID prescriptions differed, with NSAIDs having no consistently significant association with deprivation (unlike opioids/gabapentinoids).

IA analgesic prescribing of all classes is widespread, and often long-term in patients with IA.

Chronic NSAID and opioid prescriptions are commonly initiated peri-IA diagnosis, and may be the best opportunity to reduce chronic analgesic prescribing.