Osteoarthritis, NSAID Allergy Are Risk Factors for Opioid Use Disorder

Patients with osteoarthritis and nonsteroidal anti-inflammatory drug (NSAID) allergies have a higher risk of developing opioid use disorder (OUD), according to research presented at the American College of Asthma, Allergy & Immunology (ACAAI) 2020 Annual Scientific Meeting, held virtually from November 13 to November 15, 2020.

Investigators conducted a retrospective cohort study of 15,682 adult patients with osteoarthritis receiving care between January 2013 and December 2018. In total, 1442 patients (9.2%) reported a NSAID allergy.

After adjusting for baseline characteristics and comorbidities, a propensity score matched analysis showed that patients with reported NSAID allergy has significantly higher odds of developing OUD compared with patients without NSAID allergies (odds ratio [OR], 1.53; 95% CI, 1.03-2.25; P =.03). This patient population also had higher odds of a documented opioid prescription in their electronic medical records (OR, 1.23; 95% CI, 1.05-1.46; P =.01). Other risk factors for OUD in patients with osteoarthritis and reported NSAID allergy included younger age, male sex, being recipients of Medicare, Medicaid, or dual insurance; and having comorbid depression.

In patients with osteoarthritis and reported NSAID allergies, a “referral to an allergy specialist should be considered for drug allergy evaluation with potential drug challenge and allergy de-labeling,” the study authors concluded.

Reference

Li L, Chang Y, Song S, Losina E, Costenbader K, Laidlaw T. Clinical impact of reported non-steroidal anti-inflammatory drug allergies in patients with osteoarthritis. Presented at: the American College of Allergy, Asthma & Immunology (ACAAI) 2020 Annual Scientific Meeting (Virtual Experience); November 13-15, 2020. Abstract A003.