{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T13:45:29Z","timestamp":1791985529415,"version":"4.4.0"},"reference-count":47,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","award":["K01\u2010AR066878"],"award-info":[{"award-number":["K01\u2010AR066878"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100012051","name":"Lupus Research Alliance","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012051","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pain drives disability and medication use in autoimmune rheumatic diseases (ARDs), even when inflammation is controlled. The extent of pain\u2010related polypharmacy across ARDs and chronic overlapping pain conditions (COPCs) remains poorly characterized. We aimed to quantify first\u2010year pain medication burden following ARD diagnosis and examine variations by disease, COPC status, and time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using the Merative MarketScan Commercial Claims database, we identified adults newly diagnosed with rheumatoid arthritis, systemic lupus erythematosus, ankylosing spondylitis, psoriatic arthritis, Sj\u00f6gren's disease, or systemic sclerosis (2008\u20132021). We analyzed pain\u2010related medications across 10 pharmacologic categories during the first year postdiagnosis. Polypharmacy measures included counts of distinct pain medications, medication categories, \u2265\u20095 and \u2265\u200910 medication thresholds, and the Medication Quantification Scale.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>Among 149\u2009742 adults with newly diagnosed ARDs, 57.6% had at least one COPC. During the first year after diagnosis, patients filled a mean of 9.0 distinct pain medications and 47.9% met criteria for \u2265\u20095 medications; 30.5% met criteria for \u2265\u200910 medications. Ankylosing spondylitis demonstrated the highest medication burden (mean 11.6 medications; 57.5% with \u2265\u20095 medications; 37.9% with \u2265\u200910 medications). Patients with fibromyalgia had consistently higher medication burden across ARDs and were the only COPC group in whom prescribing increased from 2015 onward. Overall medication burden rose from 2008 to 2014\u20132015 and declined thereafter; however, absolute levels remained high.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>Pain\u2010related polypharmacy is common early after ARD diagnosis and varies substantially by disease and pain phenotype. Despite modest declines from 2015 onward, medication burden remains high, underscoring the need for phenotype\u2010informed, nonpharmacologic, and deprescribing strategies in rheumatology.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pds.70501","type":"journal-article","created":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T12:52:10Z","timestamp":1791982330000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["High Burden and Phenotype\u2010Specific Variability of Pain Polypharmacy in Early Autoimmune Rheumatic Diseases: A 14\u2010Year Analysis"],"prefix":"10.1002","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8720-7762","authenticated-orcid":false,"given":"Di","family":"Lu","sequence":"first","affiliation":[{"name":"Quantitative Sciences Unit, Department of Medicine Stanford University School of Medicine  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4603-863X","authenticated-orcid":false,"given":"Md. Belal","family":"Hossain","sequence":"additional","affiliation":[{"name":"Division of Immunology and Rheumatology, Department of Medicine Stanford University School of Medicine  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9873-9214","authenticated-orcid":false,"given":"Kristen","family":"Cunanan","sequence":"additional","affiliation":[{"name":"Quantitative Sciences Unit, Department of Medicine Stanford University School of Medicine  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Cragun","sequence":"additional","affiliation":[{"name":"Division of Immunology and Rheumatology, Department of Medicine Stanford University School of Medicine  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-9779-8136","authenticated-orcid":false,"given":"Lauren","family":"Vuong","sequence":"additional","affiliation":[{"name":"Division of Immunology and Rheumatology, Department of Medicine Stanford University School of Medicine  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2710-913X","authenticated-orcid":false,"given":"Macarius","family":"Donneyong","sequence":"additional","affiliation":[{"name":"Division of Pharmacy Practice and Science College of Pharmacy, the Ohio State University  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5568-388X","authenticated-orcid":false,"given":"Michael","family":"Weisman","sequence":"additional","affiliation":[{"name":"Division of Immunology and Rheumatology, Department of Medicine Stanford University School of Medicine  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0002-1907","authenticated-orcid":false,"given":"Matthew C.","family":"Baker","sequence":"additional","affiliation":[{"name":"Division of Immunology and Rheumatology, Department of Medicine Stanford University School of Medicine  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7831-4208","authenticated-orcid":false,"given":"Anushka","family":"Irani","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Medicine Mayo Clinic  Jacksonville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9580-4743","authenticated-orcid":false,"given":"Titilola","family":"Falasinnu","sequence":"additional","affiliation":[{"name":"Division of Immunology and Rheumatology, Department of Medicine Stanford University School of Medicine  Stanford California USA"},{"name":"Division of Pain Medicine, Department of Anesthesiology Stanford University School of Medicine  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,14]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI178722"},{"key":"e_1_2_11_3_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.berh.2024.101970","article-title":"Inflammatory or Non\u2010Inflammatory Pain in Inflammatory Arthritis\u2014How to Differentiate it?","volume":"38","author":"Sarzi\u2010Puttini P.","year":"2024","journal-title":"Best Practice & Research. 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