Pain Persists Despite TNF Inhibitor Use

By Jack Cush, MD | 22 October 2019

Control of pain in patients with rheumatoid arthritis (RA) often focuses on control of inflammation as a means to better control pain. However, a new claims data study shows that while anti-tumor necrosis factor inhibitor (TNFi) may lower the use of opioids, the reduction is nominal, suggesting that a substantial amount of pain is not adequately addressed by TNFi – a potent anti-inflammatory approach.

Adults with RA who were followed for > 24 months between January 2007 and December 2015 and who initiated a TNFi were included in the study. This included a total of 2330 RA patients; 38.8% of whom were using opioids at baseline and during the follow-up periods.

During the study, TNFi treated patients noted a decrease in opioid use in 54 to 51% of patients.

Also, the proportion receiving ≥ 50 mg median daily MED (median daily morphine equivalent dose) decreased from 12.6 to 10.6% following TNFi.

These real-world data suggest that opioid use among RA patients is prevalent and is not likely to change as a result of TNFi initiation.

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