A retrospective cohort study using claims data from the OptumLabs Data Warehouse highlights the significant burden of osteoporosis and opioid use on unplanned health care utilization among individuals with rheumatoid arthritis (RA), underscoring the need for targeted prevention and careful pain management strategies.

Among 862 matched pairs of patients with RA, those with a diagnosis of osteoporosis had a 23% higher risk of emergency department (ED) visits (HR: 1.23; 95% CI: 1.06–1.41; p = 0.005) and a 26% higher risk of unplanned hospitalizations (HR: 1.26; 95% CI: 1.02–1.56; p = 0.03) compared to those without osteoporosis.

“The presence of osteoporosis in RA poses a significant risk for unplanned healthcare utilization,” the authors reported at ACR Convergence.

In a subset of patients with both RA and osteoporosis, the study evaluated the impact of opioid use. Although propensity score–matched analyses did not show a difference in mortality or health care utilization, a sensitivity analysis using inverse probability of treatment weighting (IPTW) found that patients with an opioid prescription had a nearly 6-fold higher risk of 30-day ED use (HR: 5.82; 95% CI: 1.77–19.19; p = 0.004).

“These findings emphasize that opioid use in patients with osteoporosis and RA contributes to unfavorable outcomes, particularly increased ED visits,” the study concluded.

These data reinforce the importance of proactive osteoporosis management and cautious opioid prescribing, especially in older adults with RA. The results also support multidisciplinary strategies aimed at reducing fracture risk and avoiding acute care episodes in this vulnerable patient population.

Reference
Thao V, Jeffery M, Warner N, Myasoedova E. Effect of osteoporosis and opioid use on mortality and unplanned healthcare utilization among patients with rheumatoid arthritis [abstract]. Arthritis Rheumatol. 2025; 77 (suppl 9). https://acrabstracts.org/abstract/effect-of-osteoporosis-and-opioid-use-on-mortality-and-unplanned-healthcare-utilization-among-patients-with-rheumatoid-arthritis/