Opioids Associated With Infection Risk in Rheumatoid Arthritis

HealthDay News — The use of opioid analgesics may increase the risk of serious infection in patients with rheumatoid arthritis (RA), according to research published in Arthritis & Rheumatology.

Andrew D. Wiese, MD, of the Vanderbilt University Medical Center in Nashville, Tenn., and colleagues conducted a self-controlled case series analysis of data for a retrospective cohort of 13 796 patients with RA who were enrolled in Tennessee Medicaid from 1995 to 2009. Within-person comparisons were performed to examine risk of hospitalization for serious infection during periods of opioid use and non-use.

The researchers found that among 1790 patients with RA who had one or more hospitalizations for serious infection, the adjusted incidence rate of serious infection was higher for periods of current opioid use versus non-use (incidence rate ratio [IRR], 1.39; 95% confidence interval [CI], 1.19 to 1.62). Compared with periods of non-use, higher incidence rates were found during periods of long-acting opioid use (IRR, 2.01; 95% CI, 1.52 to 2.66), immunosuppressive opioid use (IRR, 1.72; 95% CI, 1.33 to 2.23), and new opioid use (IRR, 2.38; 95% CI, 1.65 to 3.42).

“In within-person comparisons of patients with RA, opioid use was associated with an increased risk of hospitalization for serious infection,” the authors write.


Wiese AD, Griffin MR, Stein CM, Mitchel EF, Grijalva CG. Opioid Analgesics and the Risk of Serious Infections Among Patients With Rheumatoid Arthritis: A Self-Controlled Case Series Study. Arthritis Rheumatol. 2016;68(2):323-31.