# Treating pain in autoimmune disease: concurrent use of opioids and biologic medication

> **NIH NIH F31** · BROWN UNIVERSITY · 2024 · $39,566

## Abstract

PROPOSAL SUMMARY
Many older adults with autoimmune disease are treated with biologic anti-inflammatory therapies (biologics) to
control their symptoms and slow disease progression. Although using opioids to treat chronic and neuropathic
pain remains controversial, they may nonetheless be commonly prescribed to older adults with autoimmune
diseases alongside biologics. Opioids are also most often prescribed to older adults, who experience an
inordinately high prevalence of inflammation, pain, and autoimmune conditions due to aging-associated changes
like immunosenescence. The effects of opioids on the immune system remain poorly understood and they may
induce immunosuppression alongside biologics, leading to increased risk of adverse events, such as severe
infection, through pharmacodynamic drug-drug interaction. Despite the coincidence of chronic inflammation and
pain in autoimmune disease, the safety outcomes from concurrent opioid and biologic use have not been
assessed. Therefore, prescribers do not have enough information on the safety of concurrent use of opioids and
biologics, and continue this practice, possibly to their patients’ detriment. This assessment of large sample of
over 3 million older adults enrolled in Medicare between 2007 and 2019 with autoimmune disease will produce
novel safety insights on the concurrent use of opioids and biologics, improving treatment outcomes for individuals
with autoimmune diseases. The long term goal of this proposal is to maintain the health and well-being of older
adults with autoimmune diseases through the optimization of treatment strategies. In service of this goal, we will
Determine the patterns and predictors of opioid use, biologic use, and concurrent opioid and biologic use across
an array of autoimmune diseases among older adults (AIM 1), assess the effects of opioid use on adherence to
biologics among older adults with autoimmune diseases (AIM 2), and examine the effects of opioids on safety
outcomes among older adults with autoimmune diseases using biologic therapies (AIM 3). These proposed
studies will be completed by the principal investigator with support and mentorship from collaborators with deep
expertise in advanced pharmacoepidemiology methods and opioid and biologics research. The principal
investigator is supported by a collaborative and interdisciplinary research environment that includes the world
renowned Center for Gerontology and Health Care Research and Department of Epidemiology at the Brown
University School of Public Health. The training activities detailed in this application, focused on advancing
quantitative computational skills and developing a deep contextual knowledge of pharmacoepidemiology, will
prepare the principal investigator for a career as an independent epidemiologist.

## Key facts

- **NIH application ID:** 10848189
- **Project number:** 5F31AG081089-02
- **Recipient organization:** BROWN UNIVERSITY
- **Principal Investigator:** Meghan Cupp Buxton
- **Activity code:** F31 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $39,566
- **Award type:** 5
- **Project period:** 2023-06-01 → 2025-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10848189

## Citation

> US National Institutes of Health, RePORTER application 10848189, Treating pain in autoimmune disease: concurrent use of opioids and biologic medication (5F31AG081089-02). Retrieved via AI Analytics 2026-05-28 from https://api.ai-analytics.org/grant/nih/10848189. Licensed CC0.

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