H Berk Degirmenci, Christine E Peloquin, Maggie Westerland, Sara Lodi, Pedro M Machado, S Reza Jafarzadeh, Tuhina Neogi, Lianne S Gensler, Maureen Dubreuil, Jean W Liew
{"title":"美国和英国过去二十年中轴性脊柱炎患者阿片类药物处方趋势：电子健康记录和保险索赔数据分析","authors":"H Berk Degirmenci, Christine E Peloquin, Maggie Westerland, Sara Lodi, Pedro M Machado, S Reza Jafarzadeh, Tuhina Neogi, Lianne S Gensler, Maureen Dubreuil, Jean W Liew","doi":"10.1002/acr.25655","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Prolonged opioid use occurs in 25% of individuals with axial spondyloarthritis (axSpA). Whether introduction of tumor necrosis factor inhibitors (TNFi) influenced secular trends in opioid prescription in axSpA is unknown. We examined opioid prescription trends in axSpA, relative to nonsteroidal anti-inflammatory drugs (NSAIDs) and TNFi, using two observational databases.</p><p><strong>Methods: </strong>We used data from IQVIA Medical Research Database (IMRD), a UK electronic health records-based database from 2000 to 2020, and Merative MarketScan (MarketScan), a US administrative claims-based database from 2006 to 2021. We included adults (18-89 years, IMRD; 18-65 years, MarketScan) with axSpA. We calculated annual prescription rates for opioids, NSAIDs, and TNFi (only in MarketScan) and estimated percentage changes in annual prescription rates by medication class using joinpoint regression.</p><p><strong>Results: </strong>We included 1,689 individuals from IMRD (mean age 47 years; 74% male) and 18,858 individuals from MarketScan (mean age 45 years; 51% male). In IMRD, annual opioid prescription rates decreased by 2.5% (95% confidence interval [CI] -9.1 to 1.9) between 2001 and 2007, increased by 3.9% (95% CI -3.0 to 14.2) between 2007 and 2016, and decreased by 0.4% (95% CI -11.2 to 2.9) between 2016 and 2020. In MarketScan, annual opioid prescription rates decreased by 1.5% (95% CI -3.0 to 2.0) in 2008 to 2016 and decreased by 8.6% (95% CI -15.2 to -5.7) in 2016 to 2021. TNFi prescriptions increased by 1.8% (95% CI 1.1 to 2.5) in 2008 to 2021.</p><p><strong>Conclusion: </strong>Opioid prescription rates remained stable over time in the United Kingdom, whereas they slightly decreased in the United States as TNFi uptake increased. These trends may reflect a US nationwide change in guidance for opioid prescriptions issued in 2016.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.3000,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12462897/pdf/","citationCount":"0","resultStr":"{\"title\":\"Trends in Opioid Prescriptions in Individuals With Axial Spondyloarthritis in the United States and United Kingdom in the Last Two Decades: Analysis of Electronic Health Records and Insurance Claims Data.\",\"authors\":\"H Berk Degirmenci, Christine E Peloquin, Maggie Westerland, Sara Lodi, Pedro M Machado, S Reza Jafarzadeh, Tuhina Neogi, Lianne S Gensler, Maureen Dubreuil, Jean W Liew\",\"doi\":\"10.1002/acr.25655\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Prolonged opioid use occurs in 25% of individuals with axial spondyloarthritis (axSpA). Whether introduction of tumor necrosis factor inhibitors (TNFi) influenced secular trends in opioid prescription in axSpA is unknown. We examined opioid prescription trends in axSpA, relative to nonsteroidal anti-inflammatory drugs (NSAIDs) and TNFi, using two observational databases.</p><p><strong>Methods: </strong>We used data from IQVIA Medical Research Database (IMRD), a UK electronic health records-based database from 2000 to 2020, and Merative MarketScan (MarketScan), a US administrative claims-based database from 2006 to 2021. We included adults (18-89 years, IMRD; 18-65 years, MarketScan) with axSpA. We calculated annual prescription rates for opioids, NSAIDs, and TNFi (only in MarketScan) and estimated percentage changes in annual prescription rates by medication class using joinpoint regression.</p><p><strong>Results: </strong>We included 1,689 individuals from IMRD (mean age 47 years; 74% male) and 18,858 individuals from MarketScan (mean age 45 years; 51% male). In IMRD, annual opioid prescription rates decreased by 2.5% (95% confidence interval [CI] -9.1 to 1.9) between 2001 and 2007, increased by 3.9% (95% CI -3.0 to 14.2) between 2007 and 2016, and decreased by 0.4% (95% CI -11.2 to 2.9) between 2016 and 2020. In MarketScan, annual opioid prescription rates decreased by 1.5% (95% CI -3.0 to 2.0) in 2008 to 2016 and decreased by 8.6% (95% CI -15.2 to -5.7) in 2016 to 2021. TNFi prescriptions increased by 1.8% (95% CI 1.1 to 2.5) in 2008 to 2021.</p><p><strong>Conclusion: </strong>Opioid prescription rates remained stable over time in the United Kingdom, whereas they slightly decreased in the United States as TNFi uptake increased. 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引用次数: 0
摘要
背景：慢性阿片类药物使用发生在25%的轴性脊柱炎（axSpA）患者中。肿瘤坏死因子抑制剂（TNFi）的引入是否影响阿片类药物处方在axSpA的长期趋势尚不清楚。我们使用两个观察性数据库，相对于非甾体抗炎药（NSAIDs）和TNFi，研究了axSpA的阿片类药物处方趋势。方法：我们使用的数据来自IQVIA医学研究数据库（IMRD），这是一个2000-2020年基于英国电子健康记录的数据库，以及Merative™MarketScan®（MarketScan），这是一个2006-2021年基于美国行政索赔的数据库。我们纳入了患有axSpA的成年人（18-89岁，IMRD； 18-65岁，MarketScan）。我们计算了阿片类药物、非甾体抗炎药和TNFi的年处方率（仅在MarketScan中），并使用联点回归估计了药物类别的年处方率的百分比变化。结果：我们纳入了来自IMRD的1,689人（平均年龄47岁，男性占74%）和来自MarketScan的18,858人（平均年龄45岁，男性占51%）。在IMRD中，阿片类药物处方率在2001-2007年间下降了2.5% (95% CI -9.1,1.9)，在2007-2016年间上升了3.9% (95% CI -3.0, 14.2)，在2016-2020年间下降了0.4% （95% CI -11.2, 2.9）。在MarketScan中，2008-2016年阿片类药物处方率下降了1.5% (95% CI -3.0, 2.0)， 2016-2021年下降了8.6% （95% CI -15.2, -5.7）。2008-2021年TNFi处方增加了1.8%（95%可信区间1.1,2.5）。结论：随着时间的推移，阿片类药物处方率在英国保持稳定，而在美国，随着TNFi摄入量的增加，阿片类药物处方率略有下降。这些趋势可能反映了2016年美国全国范围内阿片类药物处方指南的变化。
Trends in Opioid Prescriptions in Individuals With Axial Spondyloarthritis in the United States and United Kingdom in the Last Two Decades: Analysis of Electronic Health Records and Insurance Claims Data.
Objective: Prolonged opioid use occurs in 25% of individuals with axial spondyloarthritis (axSpA). Whether introduction of tumor necrosis factor inhibitors (TNFi) influenced secular trends in opioid prescription in axSpA is unknown. We examined opioid prescription trends in axSpA, relative to nonsteroidal anti-inflammatory drugs (NSAIDs) and TNFi, using two observational databases.
Methods: We used data from IQVIA Medical Research Database (IMRD), a UK electronic health records-based database from 2000 to 2020, and Merative MarketScan (MarketScan), a US administrative claims-based database from 2006 to 2021. We included adults (18-89 years, IMRD; 18-65 years, MarketScan) with axSpA. We calculated annual prescription rates for opioids, NSAIDs, and TNFi (only in MarketScan) and estimated percentage changes in annual prescription rates by medication class using joinpoint regression.
Results: We included 1,689 individuals from IMRD (mean age 47 years; 74% male) and 18,858 individuals from MarketScan (mean age 45 years; 51% male). In IMRD, annual opioid prescription rates decreased by 2.5% (95% confidence interval [CI] -9.1 to 1.9) between 2001 and 2007, increased by 3.9% (95% CI -3.0 to 14.2) between 2007 and 2016, and decreased by 0.4% (95% CI -11.2 to 2.9) between 2016 and 2020. In MarketScan, annual opioid prescription rates decreased by 1.5% (95% CI -3.0 to 2.0) in 2008 to 2016 and decreased by 8.6% (95% CI -15.2 to -5.7) in 2016 to 2021. TNFi prescriptions increased by 1.8% (95% CI 1.1 to 2.5) in 2008 to 2021.
Conclusion: Opioid prescription rates remained stable over time in the United Kingdom, whereas they slightly decreased in the United States as TNFi uptake increased. These trends may reflect a US nationwide change in guidance for opioid prescriptions issued in 2016.
期刊介绍：
Arthritis Care & Research, an official journal of the American College of Rheumatology and the Association of Rheumatology Health Professionals (a division of the College), is a peer-reviewed publication that publishes original research, review articles, and editorials that promote excellence in the clinical practice of rheumatology. Relevant to the care of individuals with rheumatic diseases, major topics are evidence-based practice studies, clinical problems, practice guidelines, educational, social, and public health issues, health economics, health care policy, and future trends in rheumatology practice.
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