We found that chronic opioid use is independently associated with a shorter period of persistence to biologic therapy. The number of biologic therapeutic options for IBD remains relatively limited, and recognition of this phenomenon is of paramount importance for preserving therapeutic options for IBD patients. Prior to abandoning a biologic therapy, we implore clinicians to remain hypervigilant for withdrawal symptoms, and ensure that patients with chronic opioid use demonstrate definitive biomarkers of ongoing disease activity such as elevated faecal calprotectin and/or endoscopic appearance. Furthermore, we suggest that clinicians involved in the care of IBD patients remain vigilant in identifying patients at risk for chronic opioid use and work with patients to find alternative methods for symptom and pain control. Future study investigating the benefit of partnerships with addiction medicine to improve outcomes in IBD is merited.
The project described was supported by the NIH National Center for Advancing Translational Sciences through grant number UL1TR001998. CP is supported by the National Institutes of Health, Grant TL1TR001997 of CCTS funding. The authors' work is also supported by the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health under Award Number R21DK118954. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
Declaration of personal interests
Dr Barrett has consulted and received honoraria for speaker's bureau activities for Takeda and AbbVie pharmaceutical companies. No other authors have disclosures to report.
Guarantor of the article
Data Availability Statement
The data that support the findings of this study are available from IBM MarketScan Research Databases. Restrictions apply to the availability of these data, which were used under license for this study. Data are available from https://www.ibm.com/products/marketscan-research-databases with the permission of IBM.
Aliment Pharmacol Ther. 2021;53(6):704-711. © 2021 Blackwell Publishing