UNC’s Andrew Moon, MD, MPH, a fellow in the division of gastroenterology and hepatology, is lead author of the study. Sidney Barritt, MD, MSCR, associate professor, is a co-author.
Target RWE, an innovative health evidence solutions company generating real-world evidence (RWE) and delivering regulatory-grade data, announced the latest data from its nonalcoholic steatohepatitis (NASH) study, published via Advanced Release (accepted, unedited manuscript) in Digestive Diseases (doi: 10.1159/000511074).
The TARGET-NASH study, Opioid Use is More Common in Non-Alcoholic Fatty Liver Disease Patients with Cirrhosis, Higher Body Mass Index and Psychiatric Disease, analyzed 3,474 adult patients with nonalcoholic fatty liver disease (NAFLD), including 18.0% with documented opioid use. Opioid use was more common in patients with more advanced liver disease (12.0% NAFL, 17.7% NASH, 23.9% NAFLD cirrhosis). Cirrhosis, depression, and anxiety were among the variables associated with opioid use. History of back pain, depression, and fibromyalgia had the greatest relative importance in predicting opioid use.
“The global burden of NAFLD is large and increasing, yet little is known regarding the prevalence of pain and associated opioid use in this population,” said Andrew Moon, MD, MPH, Fellow of Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, and lead author. “In our cohort, opioids were also associated with obesity. This was a potentially important finding because of the established link between obesity and chronic back, neck and shoulder pain, which in turn, limits mobility. For people with NAFLD, this can into a vicious cycle, as exercise has been shown to decrease hepatic steatosis and improve mobility.”
“There are many cases of people who live with both chronic pain and NAFLD receiving opioid prescriptions to help manage their pain due to the increased risk of GI and renal toxicities associated with non-steroidal anti-inflammatory drug use. There is also a perceived risk for acetaminophen use, but we know that low to normal doses are safe,” said Sidney Barritt, MD, MSCR, Associate Professor of Medicine, Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, and co-author on the study. “Given opioids’ limited long-term efficacy data and substantial risks, the findings of this analysis led us to recommend that alternative options be fully explored as first-line treatment for patients with NAFLD and pain.”
TARGET-NASH is an observational study of participants with NAFLD and/or NASH in usual clinical practice. Target RWE’s network of sites includes adult and pediatric participants across the disease spectrum in community and academic centers. Three years of retrospective and five years of prospective data are collected following enrollment, including patient-reported outcome measures and biospecimen samples.
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