Incidence of Opioid Use Before and After Parkinson's Disease Diagnosis

IF 3.5 2区医学 Q1 ANESTHESIOLOGY

European Journal of Pain Pub Date : 2025-06-09 DOI:10.1002/ejp.70056

Majd Al-Sagheer, Niina Karttunen, Anne Paakinaho, Marjaana Koponen, Valtteri Kaasinen, Sirpa Hartikainen, Miia Tiihonen, Anna-Maija Tolppanen

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引用次数: 0

Abstract

Background

Pain is a common symptom of Parkinson's disease (PD). It occurs also as a prodromal sign of PD. It has not yet been described how the use of analgesics changes over time in persons with PD. We investigated the incidence of opioid use from 5 years before to 5 years after PD diagnosis and compared the incidence to a matched cohort.

Methods

This study included 15,763 people diagnosed with incident PD in 2001–2014 and 62,907 matched comparison persons without PD from the Finnish nationwide register-based study on Parkinson's disease (FINPARK). Initiation rates of opioid use during the follow-up were calculated in 6-month time windows, and the difference between persons with and without PD was described using incidence rate ratios (IRRs).

Results

Opioid initiation was more common among persons with PD (37.0%) compared to people without PD (31.2%). The difference between the groups emerged 3 years before the PD diagnosis IRR 1.33 (1.16–1.53), and remained until the end of the follow-up. Mild opioids, such as tramadol and codeine, were the most commonly initiated opioids, and the largest difference in their use was observed 6 months prior to the diagnosis date, while differences in strong opioids emerged after the PD diagnosis. Initiation rates increased over time and remained above those of the comparison group after the PD diagnosis for all opioid classes.

Conclusions

The findings demonstrate the incidence of moderate/severe pain in PD, which requires treatment with opioid-class analgesics. Further studies are needed to understand the long-term impact of opioid use in persons with PD.

Significance Statement

Initiation rate of opioids is increased in persons with Parkinson's disease already at premotor or early motor stage, before the diagnosis is confirmed. Shift towards stronger opioids is observed over the disease progress. Further studies are needed to investigate optimized pain management strategies in Parkinson's disease.

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帕金森氏病诊断前后阿片类药物使用的发生率

疼痛是帕金森病（PD）的常见症状。它也作为帕金森病的前驱症状出现。目前还没有关于PD患者镇痛药使用随时间变化的描述。我们调查了PD诊断前5年至诊断后5年阿片类药物使用的发生率，并将发生率与匹配队列进行了比较。方法：本研究纳入了15763名2001-2014年诊断为PD的患者，以及62907名来自芬兰全国帕金森病登记研究（FINPARK）的无PD患者。在6个月的时间窗内计算随访期间阿片类药物使用的起始率，并使用发病率比（IRRs）描述PD患者和非PD患者之间的差异。结果阿片类药物起始在PD患者（37.0%）中比非PD患者（31.2%）更常见。两组之间的差异在PD诊断前3年出现IRR 1.33(1.16-1.53)，并一直持续到随访结束。轻度阿片类药物，如曲马多和可待因，是最常见的阿片类药物，其使用差异最大的是在诊断日期前6个月，而强阿片类药物的差异在PD诊断后出现。起始率随着时间的推移而增加，并且在所有阿片类药物诊断PD后仍高于对照组。结论PD患者存在中度/重度疼痛，需要阿片类镇痛药治疗。需要进一步的研究来了解阿片类药物对PD患者的长期影响。意义声明：在确诊之前，已经处于运动前期或早期运动阶段的帕金森病患者，阿片类药物的起始率增加。在疾病进展过程中观察到转向更强的阿片类药物。需要进一步的研究来研究帕金森病的最佳疼痛管理策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Pain 医学-临床神经学

CiteScore

7.50

自引率

5.60%

发文量

163

审稿时长

4-8 weeks

期刊介绍： European Journal of Pain (EJP) publishes clinical and basic science research papers relevant to all aspects of pain and its management, including specialties such as anaesthesia, dentistry, neurology and neurosurgery, orthopaedics, palliative care, pharmacology, physiology, psychiatry, psychology and rehabilitation; socio-economic aspects of pain are also covered. Regular sections in the journal are as follows: • Editorials and Commentaries • Position Papers and Guidelines • Reviews • Original Articles • Letters • Bookshelf The journal particularly welcomes clinical trials, which are published on an occasional basis. Research articles are published under the following subject headings: • Neurobiology • Neurology • Experimental Pharmacology • Clinical Pharmacology • Psychology • Behavioural Therapy • Epidemiology • Cancer Pain • Acute Pain • Clinical Trials.