Rheumatology Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Calle Dr. Esquerdo, 46, Madrid, Spain.
Universidad Complutense de Madrid, Madrid, Spain.
BMC Musculoskelet Disord. 2024 Feb 9;25(1):121. doi: 10.1186/s12891-024-07263-x.
Opioids are not recommended for fibromyalgia.
To investigate the frequency of opioid use in a large cohort of fibromyalgia patients and to identify factors associated with opioid consumption.
A retrospective, observational study of a large fibromyalgia cohort in a tertiary care center. We assessed fibromyalgia severity, functional capacity, anxiety, depression, drugs consumption and the patient's impression of change. We compared strong opioid consumers (SOC) and non-SOC. Inferential statistical and logistic regression analysis were used to identify factors associated with opioid consumption, and ANOVA for repeated measurements.
We found a prevalence of 9.2% of SOC (100 patients) among 1087 patients in the cohort. During the last four years there was a significant increase on the incidence of SOC up to 12.8% (p = 0.004). There were no differences in demographic variables between SOC and non-SOC. Clinical variables were significantly more severe in SOC, and they consumed more non-opioid drugs (p < 0.0001). Opioid consumption was independently associated with other non-opioid drugs (Odds ratio 1.25, CI: 1.13-1.38), but not with the fibromyalgia severity. At three months, 62% of the patients had opioid withdrawal. There were no statistical differences in the fibromyalgia severity at the initial evaluation, or the patient's impression of change compared with those patients who continued opioids. Coping strategies were better in those patients who withdrew opioids (p = 0.044).
We observed an increase in opioid prescriptions during the last four years. Opioid consumption was associated with concomitant use of non-opioid drugs, but it was not associated with fibromyalgia severity.
阿片类药物不推荐用于纤维肌痛。
调查大量纤维肌痛患者中阿片类药物使用的频率，并确定与阿片类药物消耗相关的因素。
对三级护理中心的大型纤维肌痛队列进行回顾性、观察性研究。我们评估了纤维肌痛的严重程度、功能能力、焦虑、抑郁、药物使用情况以及患者对变化的印象。我们比较了强阿片类药物使用者（SOC）和非 SOC。使用推断统计和逻辑回归分析来确定与阿片类药物消耗相关的因素，并使用重复测量方差分析。
我们在队列中的 1087 名患者中发现 SOC（100 名患者）的患病率为 9.2%。在过去四年中，SOC 的发病率显著增加至 12.8%（p=0.004）。SOC 和非 SOC 之间在人口统计学变量方面没有差异。SOC 的临床变量明显更严重，并且他们消耗了更多的非阿片类药物（p<0.0001）。阿片类药物消耗与其他非阿片类药物独立相关（优势比 1.25，CI：1.13-1.38），但与纤维肌痛的严重程度无关。在三个月时，62%的患者出现阿片类药物戒断。与那些继续使用阿片类药物的患者相比，在初始评估时纤维肌痛严重程度或患者对变化的印象没有统计学差异。与那些停用阿片类药物的患者相比，应对策略更好（p=0.044）。
我们观察到在过去四年中阿片类药物处方的增加。阿片类药物的消耗与非阿片类药物的同时使用有关，但与纤维肌痛的严重程度无关。
