Clinical Epidemiology Unit, Department of Clinical Sciences Lund, Orthopedics, Lund University, Lund, Sweden.
Clinical Epidemiology Unit, Skåne University Hospital, Remissgatan 4, SE-221 85, Lund, Sweden.
Clin Rheumatol. 2024 Jan;43(1):81-85. doi: 10.1007/s10067-023-06755-w. Epub 2023 Aug 28.
To investigate the association between chronic inflammatory rheumatic diseases (CIRD) and drug use disorder (DUD). Individuals aged ≥ 30 years in 2009 that met the following conditions were included: residing in the Skåne region, Sweden, with at least one healthcare contact in person and no history of DUD (ICD-10 codes F11-F16, F18-F19) during 1998-2009 (N = 649,891). CIRD was defined as the presence of rheumatoid arthritis (RA), ankylosing spondylitis (AS), psoriatic arthritis (PsA), or systemic lupus erythematosus. Treating CIRD as a time-varying exposure, we followed people from January 1, 2010 until a diagnosis of DUD, death, relocation outside the region, or December 31, 2019, whichever occurred first. We used flexible parametric survival models adjusted for attained age, sociodemographic characteristics, and coexisting conditions for data analysis. There were 64 (95% CI 62-66) and 104 (88-123) incident DUD per 100,000 person-years among those without and with CIRD, respectively. CIRD was associated with an increased risk of DUD in age-adjusted analysis (hazard ratio [HR] 1.77, 95% CI 1.49-2.09). Almost identical HR (1.71, 95% CI 1.45-2.03) was estimated after adjustment for sociodemographic characteristics, and it slightly attenuated when coexisting conditions were additionally accounted for (1.47, 95% CI 1.24-1.74). Fully adjusted HRs were 1.49 (1.21-1.85) for RA, 2.00 (1.38-2.90) for AS, and 1.58 (1.16-2.16) for PsA. More stringent definitions of CIRD didn't alter our findings. CIRD was associated with an increased risk of DUD independent of sociodemographic factors and coexisting conditions. Key Points • A register-based cohort study including 649,891 individuals aged≥30 residing in the Skåne region, Sweden, was conducted. • Chronic inflammatory rheumatic diseases were associated with higher risks of drug use disorder independent of sociodemographic factors and coexisting conditions.
探讨慢性炎症性风湿性疾病（CIRD）与药物使用障碍（DUD）之间的关联。符合以下条件的 2009 年年龄≥30 岁的个人被纳入研究：居住在瑞典斯科讷地区，在 1998-2009 年期间至少有一次亲自接受医疗保健接触，且无 DUD（ICD-10 编码 F11-F16、F18-F19）病史（N=649891）。CIRD 定义为存在类风湿关节炎（RA）、强直性脊柱炎（AS）、银屑病关节炎（PsA）或系统性红斑狼疮。将治疗 CIRD 作为时变暴露，我们从 2010 年 1 月 1 日开始随访人群，直到诊断出 DUD、死亡、搬离该地区或 2019 年 12 月 31 日，以先发生者为准。我们使用调整了获得年龄、社会人口特征和并存疾病的灵活参数生存模型进行数据分析。在没有和有 CIRD 的个体中，每 100000 人年分别有 64（95%CI 62-66）和 104（88-123）例新发 DUD。在年龄调整分析中，CIRD 与 DUD 的风险增加相关（危险比[HR]1.77，95%CI 1.49-2.09）。在调整社会人口特征后，估计出几乎相同的 HR（1.71，95%CI 1.45-2.03），当进一步考虑并存疾病时，其略有减弱（1.47，95%CI 1.24-1.74）。RA 的完全调整 HR 为 1.49（1.21-1.85），AS 为 2.00（1.38-2.90），PsA 为 1.58（1.16-2.16）。更严格的 CIRD 定义并没有改变我们的发现。CIRD 与 DUD 的风险增加相关，独立于社会人口因素和并存疾病。关键点 • 进行了一项基于登记的队列研究，纳入了 649891 名年龄≥30 岁居住在瑞典斯科讷地区的个体。• CIRD 与 DUD 的风险增加相关，独立于社会人口因素和并存疾病。
