Long-term Opioid Use in Lupus: Does Obesity Play a Role?

Hi everyone, my name is Akil Sud reporting from RheumNow. Chronic pain including long-term opioid use is common among individuals with lupus. Various factors like long-standing disease, organ damage, and even depression can contribute to this chronic pain. But where does obesity fit into the picture?

Abstract 03023 seeks to evaluate this. Through a retrospective longitudinal cohort, they evaluated whether baseline obesity defined as a BMI of 30 or higher is associated with long-term opioid prescription defined as two or more consecutive prescriptions of opioids. Through any time of the survey, about a third of the individuals were obese and factors like depression, functional disability status as well as pain were higher among obese individuals. And they found that compared to non-obese individuals, obesity was associated with nearly two-fold increased risk of long-term opioid prescription. And when adjusting for disease activity, the risk was attenuated, but the risk was still increased.

So, what do we take from this? The findings from the study are interesting and worth important consideration, but I would interpret it cautiously. The findings were collected from a survey that was largely self-reported. We don't know whether the prescriptions were actually taken by the patient who prescribed the medication and what was the indication for the prescription.

And when it comes to managing obesity for individuals with lupus, how should we treat it? Should we use medication, lifestyle changes? And I think for that answer, I think we need to take a step further back and understand where obesity fits in the overall lupus journey. For many individuals with lupus and long-standing disease and long-standing steroid use, there's a risk of weight gain and limited mobility and this can contribute to chronic pain. Furthermore, obesity may be increased by food insecurity which can heighten the risk. So, when it comes to addressing obesity in the clinic, it's important to understand what drives this and that may inform the next steps.

This is Akil Sud reporting for RheumNow. Thank you.