Jose Meade
@josemeade.bsky.social
IM PGY-3 Boston University - Interests include but not limited to PCCM, #POCUS, meded and autoimmunity #RheumCrit 🩺⚕️
6️⃣ The big picture
Early TNFi ≠ less opioid use.
Future work should include pain scores, disease activity, and social factors to fully understand pain and opioid trajectories in axSpA.
#Rheumatology #axSpA #Opioids #TNFi #Pharmacoepidemiology
Early TNFi ≠ less opioid use.
Future work should include pain scores, disease activity, and social factors to fully understand pain and opioid trajectories in axSpA.
#Rheumatology #axSpA #Opioids #TNFi #Pharmacoepidemiology
The Effect of Early Tumor Necrosis Factor Inhibitor Initiation on Chronic Opioid Use in Individuals with Axial Spondylarthritis
Objective Opioid use remains common despite effective therapies for axial spondyloarthritis (axSpA). We assessed whether early tumor necrosis factor inhibitor (TNFi) use is associated with reduced r...
acrjournals.onlinelibrary.wiley.com
October 14, 2025 at 3:15 PM
6️⃣ The big picture
Early TNFi ≠ less opioid use.
Future work should include pain scores, disease activity, and social factors to fully understand pain and opioid trajectories in axSpA.
#Rheumatology #axSpA #Opioids #TNFi #Pharmacoepidemiology
Early TNFi ≠ less opioid use.
Future work should include pain scores, disease activity, and social factors to fully understand pain and opioid trajectories in axSpA.
#Rheumatology #axSpA #Opioids #TNFi #Pharmacoepidemiology
5️⃣ Why it matters
💡 Chronic opioid use is still common (~21%) in axSpA
💥 Biologic therapy alone may not solve the opioid problem
🧠 Need multimodal, holistic pain strategies
💡 Chronic opioid use is still common (~21%) in axSpA
💥 Biologic therapy alone may not solve the opioid problem
🧠 Need multimodal, holistic pain strategies
October 14, 2025 at 3:15 PM
5️⃣ Why it matters
💡 Chronic opioid use is still common (~21%) in axSpA
💥 Biologic therapy alone may not solve the opioid problem
🧠 Need multimodal, holistic pain strategies
💡 Chronic opioid use is still common (~21%) in axSpA
💥 Biologic therapy alone may not solve the opioid problem
🧠 Need multimodal, holistic pain strategies
4️⃣ Takeaway
❌ Early TNFi use did not reduce opioid use.
📈 In opioid-naïve patients, it was linked to higher chronic use.
Likely due to confounding by indication — patients with worse disease start TNFi earlier and need more pain control.
❌ Early TNFi use did not reduce opioid use.
📈 In opioid-naïve patients, it was linked to higher chronic use.
Likely due to confounding by indication — patients with worse disease start TNFi earlier and need more pain control.
October 14, 2025 at 3:15 PM
4️⃣ Takeaway
❌ Early TNFi use did not reduce opioid use.
📈 In opioid-naïve patients, it was linked to higher chronic use.
Likely due to confounding by indication — patients with worse disease start TNFi earlier and need more pain control.
❌ Early TNFi use did not reduce opioid use.
📈 In opioid-naïve patients, it was linked to higher chronic use.
Likely due to confounding by indication — patients with worse disease start TNFi earlier and need more pain control.
3️⃣ Results
8,508 matched individuals (mean age 42, 50% women).
💊 Chronic opioid use in 20.9% overall.
⚠️ Early TNFi = higher risk (HR 1.17, 95% CI 1.06–1.28).
Opioid-naïve: HR 1.96 🚨
Opioid-experienced: NS
8,508 matched individuals (mean age 42, 50% women).
💊 Chronic opioid use in 20.9% overall.
⚠️ Early TNFi = higher risk (HR 1.17, 95% CI 1.06–1.28).
Opioid-naïve: HR 1.96 🚨
Opioid-experienced: NS
October 14, 2025 at 3:15 PM
3️⃣ Results
8,508 matched individuals (mean age 42, 50% women).
💊 Chronic opioid use in 20.9% overall.
⚠️ Early TNFi = higher risk (HR 1.17, 95% CI 1.06–1.28).
Opioid-naïve: HR 1.96 🚨
Opioid-experienced: NS
8,508 matched individuals (mean age 42, 50% women).
💊 Chronic opioid use in 20.9% overall.
⚠️ Early TNFi = higher risk (HR 1.17, 95% CI 1.06–1.28).
Opioid-naïve: HR 1.96 🚨
Opioid-experienced: NS
2️⃣ Methods
🧾 MarketScan® claims data (US)
👥 Adults 18–65 with new axSpA
⚕️ “Early TNFi” = started ≤6 months after diagnosis
📊 Propensity score–matched 1:1
💊 Outcome: chronic opioid use ≥90 days
🧾 MarketScan® claims data (US)
👥 Adults 18–65 with new axSpA
⚕️ “Early TNFi” = started ≤6 months after diagnosis
📊 Propensity score–matched 1:1
💊 Outcome: chronic opioid use ≥90 days
October 14, 2025 at 3:15 PM
2️⃣ Methods
🧾 MarketScan® claims data (US)
👥 Adults 18–65 with new axSpA
⚕️ “Early TNFi” = started ≤6 months after diagnosis
📊 Propensity score–matched 1:1
💊 Outcome: chronic opioid use ≥90 days
🧾 MarketScan® claims data (US)
👥 Adults 18–65 with new axSpA
⚕️ “Early TNFi” = started ≤6 months after diagnosis
📊 Propensity score–matched 1:1
💊 Outcome: chronic opioid use ≥90 days
1️⃣ Background
Opioid use remains high in axSpA — even with effective biologics like TNFi.
We asked: could starting TNFi early lower the risk of chronic opioid use?
Opioid use remains high in axSpA — even with effective biologics like TNFi.
We asked: could starting TNFi early lower the risk of chronic opioid use?
October 14, 2025 at 3:15 PM
1️⃣ Background
Opioid use remains high in axSpA — even with effective biologics like TNFi.
We asked: could starting TNFi early lower the risk of chronic opioid use?
Opioid use remains high in axSpA — even with effective biologics like TNFi.
We asked: could starting TNFi early lower the risk of chronic opioid use?
Reposted by Jose Meade
November 18, 2024 at 2:27 AM
Wait you also moved! @rheumcat.bsky.social
September 25, 2025 at 7:54 PM
Wait you also moved! @rheumcat.bsky.social