Tag: teenagers

Categories : Pain Management Substance UseTags :

Teens More Likely to Use Opioids when Parents Have Prescriptions

On By ModernMedia

Norwegian study of more than 21 000 young people found that those whose parents had persistent opioid prescriptions faced more than double the risk of persistent opioid use

Photo by Danilo Alvesd on Unsplash

If a parent has persistent opioid prescriptions, their adolescent or young adult offspring has more than double the risk of persistent opioid use, according to a new study published October 23rd in the open-access journal PLOS Medicine by Anna Marcuzzi of the Norwegian University of Science and Technology, Norway, and colleagues.

The prescription of strong analgesics such as opioids is not recommended for young people. However, despite potential adverse long-term consequences, opioids are often prescribed for non-malignant pain in this population.

In the new study, researchers analysed data from 21 470 adolescents and young adults aged 13-29 years who participated in the population-based Young-HUNT or HUNT Study in Norway in 2006-2008 or 2017-2019. Each participant was linked with at least one parent who also participated in the HUNT study, and opioid prescription data were obtained from the Norwegian Prescription Database.

24.4% of young people had at least one opioid prescription during the seven-year follow-up period, while 1.3% had persistent opioid prescriptions, defined as prescriptions in at least three out of four quarters of a year. When a mother had persistent opioid prescriptions over a five-year period (two years before and three years after offspring participation), their offspring had 2.60 times the risk of persistent opioid use compared to those whose mothers had no prescriptions. When a father had persistent opioid prescriptions, their offspring had 2.37 times the risk of persistent opioid use. The association was also present but weaker for non-persistent opioid prescription – offspring whose mothers had two or more prescriptions had 1.34 times the risk of receiving any opioid prescription, while those whose fathers had two or more prescriptions had 1.19 times the risk, compared to offspring whose parents had no prescriptions. There was no clear evidence that parental chronic musculoskeletal pain status influenced these associations.

The authors note that because parental opioid prescriptions were measured both before and after offspring HUNT participation, some parental opioid prescriptions could have begun after offspring opioid use. However, they conclude that there is an association between parental and offspring opioid prescriptions.

“The study findings suggest that family-based strategies should be considered when managing pain conditions in adolescents and young adults to avoid potentially unnecessary opioid use,” they say.

The authors add, “Despite restrictive opioid policies, one in four adolescents and young adults received an opioid prescription during the seven years follow-up.”

“Adolescents whose parents had two or more opioid prescriptions had a more than two-fold higher risk of persistent opioid use (ie, multiple prescriptions in a year) than if the parents had no opioid prescriptions.”

Provided by PLOS

Categories : Diseases, Syndromes and ConditionsTags :

Abrocitinib Promising in Teen Atopic Dermatitis

On By ModernMedia
Credit: National Institute of Allergy and Infectious Diseases, National Institutes of Health

Following treatment with the investigational oral Janus kinase (JAK) inhibitor abrocitinib plus topical therapy, teenagers with moderate or severe atopic dermatitis (AD) showed significant improvement to placebo, according to a new study published in JAMA Dermatology.

Up to 20% of children and adolescents are affected by AD, which has an adverse impact on QoL, academic performance, and social relationships, as well as the QoL of caregivers. Subcutaneous dupilumab is safe and effective in moderate-to-severe AD in adolescents, but there is a lack of an oral option, they said.

Nearly half of the patients had clear or almost clear skin by clinician assessment (IGA), and about 70% of patients treated with either of two doses of the JAK inhibitor had at least 75% improvement in the Eczema Area and Severity Index (EASI-75). In contrast, a fourth of patients who received placebo in addition to topical therapy met the clinician assessment outcome and about 40% met EASI-75 criteria.

Abrocitinib, a JAK-1-selective inhibitor, had already shown to be tolerable and effective in adults. The present trial included 285 patients aged 12 to 17, with coprimary endpoints being an IGA score of 0/1 with at least a two-grade improvement from baseline, plus an EASI-75 response, with both outcomes assessed at 12 weeks. Secondary endpoints included improvement in pruritis.

An IGA 0/1 response was seen in 46.2% of patients treated with abrocitinib 200 mg and 41.6% of those assigned to abrocitinib 100 mg, compared to 24.5% in the placebo group. The proportion of patients who met EASI-75 response criteria was 72% with abrocitinib 200 mg, 68.5% with abrocitinib 100 mg, and 41.5% with placebo. Significant improvement was seen in pruritis compared to placebo, showing an improvement in pruritis. The researchers noted that improved indicators could lead to better sleep and QoL indicators.

AE rates were 62.8% with the higher dose of abrocitinib, 56.8% with the lower dose, and 52.1% in the placebo group, with nausea occurring more often with abrocitinib 200 mg than with abrocitinib 100 mg (18.1% vs 7.4%).

These results suggest abrocitinib has great potential for treating teenage AD, said John C. Browning, MD, of Texas Dermatology and Laser Specialists in Dallas. Current there are no JAK inhibitors indicated for AD, and an oral option is very exciting he to MedPage Today via email. “Not everyone responds to current systemic therapies, so there is a definite need for new treatments.”

“I think more teens will be open to trying an oral option, but they will need to be committed to taking it every day,” he said, adding that compliance is an issue. “Both abrocitinib and dupilumab are effective, so there is not a tradeoff in going from injections to oral therapy.”

Source: MedPage Today