Opioid initiation among patients with rheumatoid arthritis (RA) is associated with similar major adverse
cardiovascular events (MACE) and all-cause mortality risk versus nonsteroidal anti-inflammatory drug (NSAID) initiation; however, opioids did contribute to a higher risk for venous thromboembolism, according to a study presented at the 2022 annual meeting of the American College of Rheumatology. Gulsen Ozen, MD, and colleagues assessed MACE risk with opioids versus NSAIDs in patients with RA. The analysis included matched cohorts of 4,778 opioid-initiating and 11,218 NSAID-initiating patients with RA. During the study period, there were 133 MACE in the opioid-initiating group versus 392 in the NSAID group (18.2 vs 14.6 per 1,000 personyears). Similarly, all-cause deaths were higher in the opioid group (95 deaths) versus the NSAID group (228 deaths; 12.6 vs 8.2 per 1,000 person-years). While incidence rates of MACE and all-cause mortality were lower among NSAID initiators than opioid initiators, the risk for MACE was similar in propensity-matched models as was all cause mortality.
