Opioid Use and Risk of Nonvertebral Fractures in Adults With Rheumatoid Arthritis: A Nested Case–Control Study Using Administrative Databases

摘要: Objective To assess the risk of nonvertebral fractures in patients with rheumatoid arthritis (RA) who were exposed to opioids. Methods A population-based, nested case–control study was conducted using health services administrative databases (Quebec, Canada) from 1997 2012. Among RA patients, cases 2007 2012 identified a validated algorithm. The date first fracture index for case and his/her matched control. Controls selected incidence density sampling 5:1 age, sex, diagnosis. Opioid exposure classified as current use, recent past remote nonuse. Conditional logistic regression used association opioid exposure, adjusting comorbidity, indicators severity, drugs influencing risk, care utilization. Results In total, 1,723 8,046 controls identified. these 2,595 (722 1,873 controls) had been opioids. Current use (versus nonuse) increased fracture. Cumulative opioids according quartile distribution also associated fracture: continuous 1–20 days before date, odds ratio (OR) 11.49 (95% confidence interval [95% CI] 8.81–14.99); 21–155 days, OR 1.75 CI 1.31–2.33); 156–355 1.54 1.17–2.04); ≥356 1.73 1.31–2.30). No between or observed. Conclusion Among is those treated