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Semin Arthritis Rheu:类风湿性关节炎患者开始和停止阿片类药物治疗的相关因素

2020-01-08 xiangting MedSci原创

RA患者中阿片类药物的使用率很高,这与疼痛、功能和GC治疗相关。NSAID和DMARD治疗消除了某些患者(但不是全部)使用阿片类药物的需求。

这项研究旨在确定类风湿性关节炎(RA)患者使用阿片类药物的相关因素。

2001年至2015年间,将成年RA患者(n=3225,女性73%,平均年龄57岁,中位随访时间54个月)纳入澳大利亚风湿病协会数据库(ARAD)。对于随时间变化的协变量使用logistic回归分析患者内和患者间的效应大小,对于与阿片类药物开始或停止相关的协变量使用过渡状态分析,以确定当前使用阿片类药物的决定因素。

所有阿片类药物的人群平均使用率为33%(95%CI 32-34),高效能阿片类药物的使用率为9%(95%CI 8,10),5年随访后62%的患者(95%60,64)报告使用过阿片类药物。女性阿片类药物的使用率较高,并且随着基线年龄的增加而降低。患者内的阿片类药物使用与自我报告的疼痛和HAQ评分较高(p<0.001)、NSAID(OR 1.88; 1.67-2.10)、口服糖皮质激素(2.23; 1.93-2.58)、csDMARD(2.08; 1.78-2.44)和bDMARD治疗相关(1.22; 1.06-1.40)。基线年龄小、疼痛评分高、HAQ评分和口服GC是阿片类药物使用变化的重要决定因素,并与开始使用阿片类药物的可能性较高和停用的可能性较低相关。矛盾的是,NSAID和DMARD治疗与开始使用阿片类药物的可能性较低和停用的可能性较低相关。

RA患者中阿片类药物的使用率很高,这与疼痛、功能和GC治疗相关。NSAID和DMARD治疗消除了某些患者(但不是全部)使用阿片类药物的需求。

原始出处:

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    2020-01-10 lmm397
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    2020-01-10 lhlxtx
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    2020-01-10 zhaojie88
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