{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T00:49:20Z","timestamp":1769215760785,"version":"3.49.0"},"reference-count":22,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T00:00:00Z","timestamp":1762819200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T00:00:00Z","timestamp":1762819200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100018578","name":"Clinical and Translational Science Institute, Boston University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100018578","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100020853","name":"Spondyloarthritis Research and Treatment Network","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100020853","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100012495","name":"Spondylitis Association of America","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012495","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006260","name":"Rheumatology Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006260","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000980","name":"Arthritis Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000980","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K23 AR082938"],"award-info":[{"award-number":["K23 AR082938"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K24 AR070892"],"award-info":[{"award-number":["K24 AR070892"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["P30 AR072571"],"award-info":[{"award-number":["P30 AR072571"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp; Research"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Opioid use remains common despite effective therapies for axial spondyloarthritis (axSpA). We assessed whether early tumor necrosis factor inhibitor (TNFi) use is associated with reduced risk of chronic opioid use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using the Merative MarketScan Commercial Database containing health insurance billing claims data, we conducted a time\u2010stratified, propensity score (PS)\u2013matched cohort study of adults aged 18 to 65\u2009years with axSpA. Early TNFi exposure was defined using pharmacy and medical claims as any incident TNFi use within 6\u2009months of axSpA diagnosis. We used PSs to match early TNFi users 1:1 to those not starting a TNFi within 6\u2009months in 1\u2010year cohort accrual blocks. We compared the risk of chronic opioid use (\u226590\u2009days\u2019 prescription) among early TNFi users versus comparators using Cox proportional hazard models, overall and stratified by prior opioid use (within 12\u2009months).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We included 8,508 individuals with axSpA after PS matching (4,254 early TNFi initiators and 4,254 comparators) with a mean age of 42\u2009years; 50% were female. Chronic opioid use occurred in 20.9% (22.3% early TNFi initiators and 19.6% comparators). Early TNFi initiators had 17% higher risk of chronic opioid use versus matched comparators (95% confidence interval [CI] 1.06\u20131.28), with higher risk of chronic opioid use for early TNFi initiators in the opioid\u2010naive but not in the opioid\u2010experienced stratum (hazard ratio [HR] 1.96; 95% CI 1.41\u20132.74 vs HR 1.06; 95% CI 0.96\u20131.17).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Early TNFi initiation was not associated with reduced risk of chronic opioid use versus later or no TNFi initiation. Confounding by indication in administrative claims data limit result interpretation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acr.25659","type":"journal-article","created":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T05:45:54Z","timestamp":1760420754000},"page":"76-84","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of Early Tumor Necrosis Factor Inhibitor Initiation on Chronic Opioid Use in Individuals With Axial Spondyloarthritis"],"prefix":"10.1002","volume":"78","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9919-1593","authenticated-orcid":false,"given":"Eva","family":"Petrow","sequence":"first","affiliation":[{"name":"Boston University Chobanian &amp; Avedisian School of Medicine  Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1582-4822","authenticated-orcid":false,"given":"Jose A.","family":"Meade\u2010Aguilar","sequence":"additional","affiliation":[{"name":"Boston University Chobanian &amp; Avedisian School of Medicine  Boston Massachusetts"},{"name":"Department of Medicine Boston University Chobanian &amp; Avedisian School of Medicine  Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine","family":"Peloquin","sequence":"additional","affiliation":[{"name":"Boston University Chobanian &amp; Avedisian School of Medicine  Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1099-9175","authenticated-orcid":false,"given":"S. Reza","family":"Jafarzadeh","sequence":"additional","affiliation":[{"name":"Boston University Chobanian &amp; Avedisian School of Medicine  Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9515-1711","authenticated-orcid":false,"given":"Tuhina","family":"Neogi","sequence":"additional","affiliation":[{"name":"Boston University Chobanian &amp; Avedisian School of Medicine  Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6253-1515","authenticated-orcid":false,"given":"Maureen","family":"Dubreuil","sequence":"additional","affiliation":[{"name":"Boston University Chobanian &amp; Avedisian School of Medicine  Boston Massachusetts"},{"name":"VA Boston Healthcare System  Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8104-2450","authenticated-orcid":false,"given":"Jean","family":"Liew","sequence":"additional","affiliation":[{"name":"Boston University Chobanian &amp; Avedisian School of Medicine  Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,11,11]]},"reference":[{"issue":"13","key":"e_1_2_7_2_1","first-page":"1303","article-title":"Ankylosing spondylitis and axial spondyloarthritis","volume":"375","author":"Taurog JD","year":"2016","journal-title":"N Engl J Med"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2024.20917"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.24025"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard-2022-223296"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.2023-0194"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbspin.2023.105670"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2012-203201"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.180972"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-027495"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.170630"},{"issue":"10","key":"e_1_2_7_12_1","first-page":"1009","article-title":"Opioid use and healthcare utilization in adults with psoriatic arthritis and ankylosing spondylitis","volume":"51","author":"Liew JW","year":"2024","journal-title":"J Rheumatol"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-018-1941-1"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keae444"},{"key":"e_1_2_7_15_1","unstructured":"IBM MarketScan Research Databases for life sciences researchers. 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