OPIOID USE IN PATIENTS WITH FIBROMYALGIA: A RETROSPECTIVE CLAIMS ANALYSIS

Background

Fibromyalgia (FM) is a chronic pain disorder that presents significant diagnostic and therapeutic challenges, compounded by the presence of multiple comorbidities. Despite approved therapies for FM, opioids continue to be widely prescribed in patients with FM for pain management. This study (1) quantified the use of opioids and benzodiazepines in patients diagnosed with FM via a retrospective claims database analysis and (2) characterized patients by age, insurance coverage, and polypharmacy.

Methods

This is a retrospective database analysis conducted using closed claims from the Symphony database (04/2021 – 04/2024). The patient cohort was defined as adult (aged ≥ 18 years) patients with FM identified via the presence of FM ICD-10-CM code anytime during the study period. Opioid use captures patients with ≥1 pharmacy claim for any opioid drugs during the study period. The results presented comprise the third year (2023-2024; Y3 cohort).

Results

A total of 261,776 patients were included in the Y3 cohort. The mean (SD) age of the cohort was 52.3 (13.02) years. The majority of patients (92.1%) were female, and 49.6% patients were white non-Hispanic. Among these patients with FM, 48.3% (n=126,391) were covered under Commercial or Medicare Advantage insurance. Of these 126,391 patients, 40.2% of patients were prescribed opioids, with most claims for tramadol (13.7%), followed by oxycodone (13.1%). The average medical possession ratio (MPR) was 0.39. Opioid use observed among patients across all payer types (Commercial, Medicaid, and Medicare) in the age groups 61-65 (n=35,471), 66-70 (n=15,403), 71-75 (n=9,533), and > 75 (n=10,123), was 43.1%, 39.2%, 38.5% and 34.4%, respectively. By comparison, opioid use was lower in the 18-25 age group (12.5%; n=5,982). Concomitant opioid and benzodiazepine use, a polypharmacy choice that often elicits harmful side effects and contradicts guidelines, was observed in 19.1% of patients covered under Medicare Advantage or Commercial insurance. In age groups 61-65, 66-70, 71-75, and > 75, concomitant opioid and benzodiazepine use was 20.9%, 17.9%, 16.4% and 15.6%, respectively. Use was even higher among geriatric women with sleep issues (n=68,319) at 22.7%.

Conclusions

This study quantifies opioid use in patients with FM. Furthermore, it provides valuable insight into the increased risk that geriatric patients with FM are exposed to due to concomitant opioid and benzodiazepine use. The persistent, prevalent use of opioids, despite not being indicated for FM, highlights the need for safer, more effective non-opioid analgesics for FM.Funding: This study and support for this abstract were funded by Tonix Medicines, Inc. (Chatham, NJ)