Depression, anxiety, chronic pain, and opioid use are common in inflammatory arthritis and associated with earlier tumor necrosis factor inhibitor (TNFi) discontinuation, according to a study published in Clinical Rheumatology. Guy Katz, MD, and colleagues conducted a retrospective cohort study to identify patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), and ankylosing spondylitis (AS) initiating a first TNFi. Depression/anxiety, chronic pain, and opioid use were identified using diagnosis codes and prescription fill data. Cox proportional hazards models were used to compare time to discontinuation in patients with or without each of these risk factors and to assess the impact of multiple risk factors. Among 33,744 patients initiating a TNFi, depression/anxiety, chronic pain, and opioid use were common, with one or more risk factors in 48.1%, 42.5%, and 55.4% of patients with RA, PsA, and AS, respectively. Each risk factor individually was associated with a 5- to 7-month lower median treatment persistence in each disease.
