Risk for Long-Term Opioid Use Up in Hidradenitis Suppurativa

Patients with hidradenitis suppurativa (HS) have an increased risk for long-term opioid use, according to a study published online in JAMA Dermatology.

Sarah Reddy, from the Zucker School of Medicine at Hofstra/Northwell in New Hyde Park, New York, and colleagues compared overall and subgroup incidence of long-term opioid use in a retrospective cohort study involving 22,277 patients with HS and 828,832 controls identified using electronic health records data.

The researchers found that crude one-year incidence of long-term opioid use was 0.33 and 0.14 percent among opioid-naive patients with HS and controls, respectively. In an adjusted analysis, the odds of new long-term opioid use were 1.53-fold higher for HS patients compared with controls (95 percent confidence interval [CI], 1.20 to 1.95; P < 0.001). Among patients with HS, higher odds of long-term opioid use were seen in association with advancing age (odds ratio, 1.02 per one-year increase; 95 percent CI, 1.00 to 1.03; P = 0.05), ever smoking (odds ratio, 3.64; 95 percent CI, 2.06 to 6.41; P < 0.001), history of depression (odds ratio, 1.97; 95 percent CI, 1.21 to 3.19; P = 0.006), and baseline Charlson comorbidity index score (odds ratio, 1.15 per 1-point increase; 95 percent CI, 1.03 to 1.29; P = 0.01). During the study period, 5.4 percent of patients with HS and long-term opioid use were diagnosed with opioid use disorder. Patients were prescribed the most opioids in the primary care, anesthesiology/pain management, gastroenterology, surgery, and emergency medicine disciplines.

"Our hope is that the medical community, including dermatologists, will further embrace and engage in an integrated care plan that comprehensively supports the needs of patients with HS, including pain management," the authors write.

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