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Decrease in the incidence of total hip arthroplasties in patients with rheumatoid arthritis - results from a well defined population in south Sweden

Hekmat, Korosh LU ; Jacobsson, Lennart LU ; Nilsson, Jan-Åke LU ; Petersson, Ingemar LU ; Robertsson, Otto LU ; Garellick, Goran and Turesson, Carl LU (2011) In Arthritis Research and Therapy 13(2).
Abstract
Introduction: One aim of modern pharmacologic treatment in rheumatoid arthritis (RA) is to prevent joint destruction and reduce the need for surgery. Our purpose was to investigate secular trends in the incidence of primary total hip and knee arthroplasties in a well defined sample of patients with RA. Methods: Prevalent cases with RA in 1997 and incident cases from 1997 to 2007 in a community based register in Malmo, south Sweden, were included. Based on a structured review of the medical records, patients were classified according to the 1987 ACR criteria for RA. This cohort was linked to the Swedish Hip Arthroplasty Register (through December 2006) and the Swedish Knee Arthroplasty Register (through October 2007). Patients with a... (More)
Introduction: One aim of modern pharmacologic treatment in rheumatoid arthritis (RA) is to prevent joint destruction and reduce the need for surgery. Our purpose was to investigate secular trends in the incidence of primary total hip and knee arthroplasties in a well defined sample of patients with RA. Methods: Prevalent cases with RA in 1997 and incident cases from 1997 to 2007 in a community based register in Malmo, south Sweden, were included. Based on a structured review of the medical records, patients were classified according to the 1987 ACR criteria for RA. This cohort was linked to the Swedish Hip Arthroplasty Register (through December 2006) and the Swedish Knee Arthroplasty Register (through October 2007). Patients with a registered total hip or knee arthroplasty before 1997 or before RA diagnosis were excluded. Incidence rates for the period of introduction of TNF inhibitors (1998 to 2001) were compared to the period when biologics were part of the established treatment for severe RA (2002 to 2006/2007). Results: In the cohort (n = 2,164; 71% women) a primary hip arthroplasty was registered for 115 patients and a primary knee arthroplasty for 82 patients. The incidence of primary total hip arthroplasties decreased from the period 1998 to 2001 (12.6/1,000 person-years (pyr)) to 2002 to 2006 (6.6/1,000 pyr) (rate ratio (RR) 0.52; 95% confidence interval (CI) 0.35 to 0.76). There was a trend towards an increase of primary knee arthroplasties (incidence 4.8/1,000 pyr vs. 6.8/1,000 pyr; RR 1.43; 95% CI 0.89 to 2.31). Conclusions: Our investigation shows a significant decrease in the incidence of total hip arthroplasties in patients with RA after 2001. Possible explanations include a positive effect on joint damage from more aggressive pharmacological treatment. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Arthritis Research and Therapy
volume
13
issue
2
publisher
BioMed Central
external identifiers
  • wos:000292449700032
  • scopus:79954576665
ISSN
1478-6362
DOI
10.1186/ar3328
language
English
LU publication?
yes
id
bca32099-b46d-4311-85b3-8b3d33d6bcab (old id 2029127)
date added to LUP
2011-08-02 08:56:55
date last changed
2017-08-06 03:17:02
@article{bca32099-b46d-4311-85b3-8b3d33d6bcab,
  abstract     = {Introduction: One aim of modern pharmacologic treatment in rheumatoid arthritis (RA) is to prevent joint destruction and reduce the need for surgery. Our purpose was to investigate secular trends in the incidence of primary total hip and knee arthroplasties in a well defined sample of patients with RA. Methods: Prevalent cases with RA in 1997 and incident cases from 1997 to 2007 in a community based register in Malmo, south Sweden, were included. Based on a structured review of the medical records, patients were classified according to the 1987 ACR criteria for RA. This cohort was linked to the Swedish Hip Arthroplasty Register (through December 2006) and the Swedish Knee Arthroplasty Register (through October 2007). Patients with a registered total hip or knee arthroplasty before 1997 or before RA diagnosis were excluded. Incidence rates for the period of introduction of TNF inhibitors (1998 to 2001) were compared to the period when biologics were part of the established treatment for severe RA (2002 to 2006/2007). Results: In the cohort (n = 2,164; 71% women) a primary hip arthroplasty was registered for 115 patients and a primary knee arthroplasty for 82 patients. The incidence of primary total hip arthroplasties decreased from the period 1998 to 2001 (12.6/1,000 person-years (pyr)) to 2002 to 2006 (6.6/1,000 pyr) (rate ratio (RR) 0.52; 95% confidence interval (CI) 0.35 to 0.76). There was a trend towards an increase of primary knee arthroplasties (incidence 4.8/1,000 pyr vs. 6.8/1,000 pyr; RR 1.43; 95% CI 0.89 to 2.31). Conclusions: Our investigation shows a significant decrease in the incidence of total hip arthroplasties in patients with RA after 2001. Possible explanations include a positive effect on joint damage from more aggressive pharmacological treatment.},
  articleno    = {R67},
  author       = {Hekmat, Korosh and Jacobsson, Lennart and Nilsson, Jan-Åke and Petersson, Ingemar and Robertsson, Otto and Garellick, Goran and Turesson, Carl},
  issn         = {1478-6362},
  language     = {eng},
  number       = {2},
  publisher    = {BioMed Central},
  series       = {Arthritis Research and Therapy},
  title        = {Decrease in the incidence of total hip arthroplasties in patients with rheumatoid arthritis - results from a well defined population in south Sweden},
  url          = {http://dx.doi.org/10.1186/ar3328},
  volume       = {13},
  year         = {2011},
}