VIDEO: Opioid use more common in chronic liver disease than other chronic diseases

SAN FRANCISCO — In this exclusive video perspective from The Liver Meeting 2018, Monica Konerman, MD, director of the Michigan Medicine NAFLD Clinic, discusses results of a study that found opioid use to be twice as common among patients with chronic liver disease compared with other common chronic diseases.

“We were very interested to try and figure out what the overall prevalence of opioid use is in patients with chronic liver disease because right now we know that there is an opioid epidemic, but we don’t really have good data in terms of how many patients with chronic liver disease are actually using prescription opioids,” Konerman told Healio Gastroenterology and Liver Disease.

The study comprised 210,191 patients with hepatitis C without cirrhosis and 79,332 patients with cirrhosis from any cause. The comparative cohort included 766,840 patients with congestive heart failure (CHF) and 1,438,798 patients with chronic obstructive pulmonary disease (COPD). Data were from 2009 to 2015.

The prevalence of prescription opioid use per person-years was 24.9% in patients with chronic HCV and 53% in those with cirrhosis compared with 26% in CHF and 24.3% in COPD.

“We were also interested in the use of benzodiazepines because we know, based on the hepatic metabolism of those medications also, there are potential adverse consequences in individuals with chronic liver disease,” she said.

The prevalence of benzodiazepine use per person-years was 12.3% in patients with chronic HCV and 21.3% in those with cirrhosis compared with 12.1% in CHF and 12.9% in COPD.

Patients aged 40 years to 59 years had the highest rates of opioid use (P < .001).

Additionally, dual-use of both opioids and benzodiazepines was higher among patients with chronic liver disease compared with the other common chronic diseases.

“In this specific study, we did not look at clinical outcomes related with use, but that is certainly something that we’re interested in and actively working on, because — again — given that these are hepatically metabolized we worry that high rates of use could be potentially associated with adverse clinical outcomes,” Konerman said.

Reference:

Konerman MA, et al. Abstract 0758. Presented at: The Liver Meeting 2018; Nov. 9-13, 2018; San Francisco.

Disclosure: Konerman reports no relevant financial disclosures.