Opioid use in psoriatic arthritis is associated with higher healthcare costs and usage

New avenues of care are needed to improve healthcare spending.

Patients with psoriatic arthritis (PsA) or ankylosing spondylitis (AS) who use opioids have higher health care utilization and associated costs, according to research presented at ACR Convergence 2022, held March 10-14 November in Philadelphia, Pennsylvania.1

The use of opioids in people with spondyloarthritis is common; Reports indicate rates of opioid use between 20% and 30% in some patient cohorts. However, data on healthcare utilization among these patients are lacking. Therefore, researchers conducted a retrospective cohort study of adult patients with PsA or AS enrolled in FORWARD, the National Rheumatic Diseases Database. Patients who completed one or more Health Assessment Questionnaire-Disability Index and/or Bath Ankylosing Spondylitis Disease Activity Index between 2010 and 2019 were included in the study.

The cohort included a total of 828 patients with PsA and 334 patients with AS, of whom 21.3% (n=177) and 27.4% (n=91) were using opioids. These patients had more comorbidities, higher smoking prevalence, and poorer disease activity as measured by questionnaire. These patients also tended to have higher use of all antirheumatic drug classes. Those who took opioids were more likely to have higher health care utilization and medical expenses, including doctor visits, diagnostic tests, direct medical expenses, and pharmacy expenses such as biologics or other medications.

After adjusting for age, gender, and hospital admissions, patients with PsA who took opioids had 33% more visits to the doctor each year than patients who did not take opioids; Results were similar in the AS cohort, with a 32% increase in annual physician visits. The annual number of diagnostic tests was “similarly increased” in opioid users (56% and 68% in the PsA and AS groups, respectively). Those taking opioids also spent more annually on doctor visits ($3464.70 and $4576.20, respectively). These patients also spent more on drugs such as biologics, conventional synthetic disease-modifying anti-inflammatory drugs, and other drug-related costs.

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“New treatment pathways for these patients are needed to improve care and reduce costs,” the researchers concluded.


1. Ogdie A, Pedro S, Liew J, Michaud K. Opioid use and health care in adults with PsA and AS. Presented at: American College of Rheumatology Convergence 2022; 10-14/11/2022; Philly, PA. Summary 0402.

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