Trends in Use of Prescribed Opioids in Incident and Prevalent Patients With Ulcerative Colitis: A Nationwide Study in Sweden

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BACKGROUND AND AIMS: Opioids are not optimal for managing pain among patients with ulcerative colitis (UC), but the use of opiods in nationwide UC populations remains unexplored. We aimed to describe dispensed opioid use around UC diagnosis and annual trends among patients with prevalent UC. METHODS: We performed a nationwide population-based cohort study of adults with an incident (2008-2020) or a prevalent (2006-2022) UC diagnosis and matched reference individuals from the general population. We obtained data on opioid dispensations and estimated the prevalence of having ≥1 dispensation per six-month period from two years before until five years following a first UC diagnosis. We also estimated annual opioid use among participants with a prevalent UC diagnosis and their matched reference individuals. RESULTS: Overall, 66 929 adults with UC (including 25 417 patients with an incident diagnosis) and 641 609 matched reference individuals were included. Compared to reference individuals, patients with UC had a 1.3-fold higher prevalence of opioid use (6.4% vs 4.9%) two years before diagnosis, which peaked during the year of diagnosis (11.0%) and stabilized at a 1.7-fold higher use three to five years after diagnosis. Between 2006 and 2022 the annual prevalence of opioid use decreased by 15.0% in patients with UC and by 11.0% in reference individuals. CONCLUSION: In this nationwide register-based study, adults with UC had higher prescribed opioid use within two years before and up to five years after first UC diagnosis compared with reference individuals. However, adults with prevalent UC (and reference individuals) had a declining temporal opioid use trend during 2006-2022.

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