Opioids pose infection risk to patients with RA pain

People suffering from rheumatoid arthritis (RA) are vulnerable to serious infection, the risk of which is compounded by opioid analgesics.

People suffering from rheumatoid arthritis (RA) are vulnerable to serious infection, the risk of which is compounded by opioid analgesics. Looking at data from nearly 14,000 Tennessee Medicaid enrollees with the condition, researchers from Vanderbilt University found risk of infection to be almost 40% greater during periods of opioid use compared with periods of nonopioid use. "The highest rates of infections were associated with the current use of long-acting opioids, high doses of opioids and opioids with potentially immunosuppressive properties," according to first author Andrew Wiese, MPH. Although opioids typically are not the first line of defense against RA, Petros Efthimiou, MD, of Weill Cornell Medical College, said it will be important to explain this risk to patients in cases when doctors do prescribe opioid analgesics. While he was not involved in the Vanderbilt study, Efthimiou said the findings add credibility to a suspected correlation between opioids and immunodepression. Wiese noted that further investigation must focus on specific opioids and formulations. "That additional information could then inform the selection of appropriate pain control medications in susceptible populations," he concluded. The research is reported in Arthritis & Rheumatology.