PDG37 OPIOID USE IN COLOMBIAN PATIENTS DIAGNOSED WITH RHEUMATOID ARTHRITIS

Abstract

To determine the trend of the use of opioid analgesics in Colombian patients diagnosed with rheumatoid arthritis (RA) treated in a multicentric cohort in 21 cities of Colombia from 2011 to 2017. Retrospective cohort observational study, which included adult patients with RA under management by IPS-E in Colombia, We included patients with diagnosis between January 1, 2011 and December 31, 2012, taking the first visit with rheumatology as an index date in this period; And a monthly follow-up of the medication received with interest in the use of opioids and other analgesics was carried out until December 31, 2017, patients with loss of follow-up or death were censored. Sociodemographic variables, use of opioids and concomitant prescriptions were evaluated. Multivariate analyzes were performed in SPSS 24.0 We included 1329 patients with a diagnosis of RA in treatment and follow-up. With a mean age of 61.2 ± 11.8 years and female predominance (n = 936, 82.9%). During the months of follow-up (60 - 84 months) a total of 1129 (84.9%) patients used an opioid, and an increasing trend of use in the cohort during follow-up. 46.7% of patients used opioids for more than 12 months. The most commonly used opioids were codeine (76.3%) and tramadol (71.1%). For the management of RA, it was found that all patients use conventional DMARDs and 179 (15.9%) use biological DMARDs, 966 systemic corticosteroids (85.6%) and non-steroidal anti-inflammatory drugs in 834 patients (73.9%). In this cohort of patients undergoing treatment for RA, a high proportion of opioid use was found for adjuvant analgesic therapy, many of them for prolonged periods of time, in which safety and tolerance considerations make this situation a point to monitor and intervene in this population.