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THR/TKR Rates, and bDMARDs in Patients with RA
Ann Rheum Dis; 2018 May; Cordtz, Hawley, et al
The incidence rate of total hip replacement (THR) and total knee replacement (TKR) was 3-fold and 14-fold higher, respectively, among patients with rheumatoid arthritis (RA) compared with general population comparators (GPCs) in 1996, a recent interrupted time-series analysis found. In patients with RA, introduction of biological disease-modifying anti-rheumatic drugs (bDMARDs) was associated with a decreasing incidence rate of TKR, whereas the incidence of THR had started to decrease before bDMARD introduction. Patients with incident RA between 1996 and 2011 were identified in a national cohort and matched on age, sex, and municipality with up to 10 GPCs. 30,404 patients with incident RA and 297,916 GPCs were identified. Researchers found:
- In 1996, the incidence rate of THR and TKR was 8.72 and 5.87, respectively, among patients with RA, and 2.89 and 0.42 in GPCs.
- From 1996 to 2016, the incidence rate of THR decreased among patients with RA, but increased among GPCs.
- Among patients with RA, the incidence rate of TKR increased from 1996 to 2001, but started to decrease from 2003 and throughout the bDMARD era.
- The incidence of TKR increased among GPCs from 1996 to 2016.
Cordtz RLO, Hawley S, Prieto-Alhambra, et al. Incidence of hip and knee replacement in patients with rheumatoid arthritis following the introduction of biological DMARDs: An interrupted time-series analysis using nationwide Danish healthcare registers. Ann Rheum Dis. 2018;77(5): 684-689. doi:10.1136/annrheumdis-2017-212424.