Opioid use in patients with NAFLD: prevalence and association with comorbidities and disease severity.

Challenge

Opioid analgesics carry elevated risk in liver disease, yet the prevalence of opioid use across the NAFLD spectrum and its association with comorbidities, disease severity, and psychiatric burden had not been characterized in a large, prospective real-world cohort.

Solution

The TARGET-NASH cohort was analyzed to quantify opioid use prevalence across NAFL, NASH, and cirrhosis disease groups and identify independent predictors of opioid use through multivariable stepwise regression, providing the first real-world characterization of this safety-relevant prescribing pattern.

Impact

Establishing that approximately 1 in 5 NAFLD patients uses opioids—with significantly higher rates in cirrhosis, high BMI, and psychiatric comorbidity—provides a direct safety surveillance signal for NAFLD drug developers and supports the design of concomitant medication monitoring policies in NAFLD trials.