Incidence and time trends of joint surgery in patients with psoriatic arthritis: a register-based time series and cohort study from Denmark

Abstract

ObjectiveTo investigate time-trends and cumulative incidence of joint surgery among patients with psoriatic arthritis (PsA) compared with the general population.MethodsIn this nationwide register-based cohort study, The Danish National Patient Registry was used to identify incident PsA patients. The 5-year incidence rates (IR) and incidence rate ratios (IRR) of joint surgery were calculated in four calendar-period defined cohorts. Each patient was matched with ten non-PsA individuals from the general population cohort (GPC). The cumulative incidences of any joint and joint-sacrificing surgery, respectively, were estimated using the Aalen-Johansen method.ResultsFrom 1996 to 2017, 11 960 PsA patients (mean age 50 years; 57% female) were registered. The IRR of any joint surgery was twice as high for PsA patients compared with GPCs across all calendar periods. Among patients with PsA, 2, 10 and 29% required joint surgery at 5, 10 and 15 years after diagnosis. The risk of surgery in PsA patients diagnosed at 18–40 years was higher (22%) than in GPC 60+ year old (20%) after 15 years of follow-up.ConclusionsThe use of joint surgery among PsA patients remained around twofold higher from 1996 to 2012 compared with GPC. After 15 years of follow-up, nearly 30% of the PsA patients had received any surgery, and even a person diagnosed with PsA at the age of 18–40 years had a higher risk of surgery than GPCs of 60+ year old. Thus, the high surgical rates represent an unmet need in the current treatment of PsA.

Agreement Between Self-Reported Information and Administrative Data on Comorbidities, Imaging and Treatment in Denmark – A Validation Study of 38,745 Patients with Knee or Hip Osteoarthritis

“…Surgical procedures have been coded in DNPR according to the Nordic Medico-Statistical Committee (NOMESCO) system since 1996. 30 Previous studies have shown that data on surgical procedures in DNPR is valid. [31][32][33] The results of this study indicate that there is almost perfect agreement between GLA:D and registry-based data on the knee and hip replacement surgery at baseline and followup.…”

Perioperative management of patients with inflammatory rheumatic diseases

“…Since the introduction of bDMARD therapies in the early 2000s, surgical interventions have fortunately decreased, not only in Germany but also in many other countries [49][50][51][52][53]. Nevertheless, surgical interventions are still more frequent in patients with inflammatory rheumatic diseases than in the healthy population [54]. Complications following surgery, on the other hand, appear to be declining over time.…”

Trends in orthopaedic surgery for spondyloarthritis: outcomes from a National Hospitalised Patient Registry (MBDS) over a 17-year period (1999–2015).TREND-EspA study

“…However, no reduction in the OS trend was found in those studies, in which only patients with PsA were analysed. Guldberg-Møller et al 17 analysed 11 960 patienst with PsA (mean age 50 years; 57% female) from 1996 to 2017. The IRR of any joint surgery was two times as high for patients with PsA as for the general population across all the calendar periods analysed.…”

“…The study by Abraham et al (between 2002 and 2013) revealed an increasing trend towards knee arthroplasties in patients with spondylitis in a sample obtained in their nationwide inpatient sample 15. Other studies found a decreasing trend in hip arthroplasties for patients with AS,16 although another study on PsA did not find a decreasing trend in arthroplasties 17. As for other types of SpA (eg, SpA-IBD and ReA), studies are manifestly scarce.…”