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

Cordtz, René; Hawley, Samuel; Prieto‐Alhambra, Daniel; Højgaard, Pil; Zobbe, Kristian; Overgaard, Søren; Odgaard, Anders; Kristensen, Lars Erik; Dreyer, Lene

doi:10.1136/annrheumdis-2017-212424

Cited by 55 publications

(42 citation statements)

References 30 publications

(14 reference statements)

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“…A further meta-analysis by C. Mabille et al (2017) provided similar findings [65]. In a very recent one by R. L. Cordtz et al (2018) [1], the risk of prosthetic joint infection (PJI) was assessed in the RA patients treated and untreated with biological agents for 90 days after hip and knee re-placement. Authors studied several Danish registers.…”

Section: Postoperative Infection Risk Of the Patients Receiving Biolomentioning

confidence: 80%

“…A range of studies show that the RA patients have an elevated risk of postoperative infection due to the orthopedic interventions [19][20][21][22]. R. L. Cordtz et al (2018) [20] recruited 3913 RA patients having undergone hip and knee replacements from the Danish register and found a higher infection risk for the replacements (odds ratio (OR) 1.46). A similar study with the national sample data for the in-patients revealed higher values for the postoperative infections, suture inconsistency, and long-term wound healing, system-ic complications of the hip and knee replacements in comparison with osteoarthritis patients [21].…”

Section: Postoperative Infection Risk In the Ra Patientsmentioning

confidence: 99%

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Менеджмент Пацієнтів З Ревматоїдним Артритом У Періопераційному Періоді

Syniachenko¹,

Golovach²,

Yehudіna³

2021

PJS

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Despite the rapid development of biological therapy and decisive establishment of such medication in the rheumatic disease management, rheumatoid arthritis (RA) patients are often subjected to orthopedic surgical interventions [1]. Joint endoprosthetics, arthroplasty, arthroscopic debridement, tendon reconstruction, rheumatoid nodule removal, tunnel and wrist canal decompression-all of these procedures , and numerous others, make up a list of orthopedic interventions indicated to treat rheumatoid arthritis. Furthermore, the RA patients undergo surgery due to their somatic conditions much more often than the rest of the population [1]. Perioperative period involves a number of infection-related risks, such as surgical wound infection and pneumonia. Arthroplasty and other interventions involving prosthet

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Section: Postoperative Infection Risk Of the Patients Receiving Biolomentioning

confidence: 80%

Section: Postoperative Infection Risk In the Ra Patientsmentioning

confidence: 99%

Менеджмент Пацієнтів З Ревматоїдним Артритом У Періопераційному Періоді

Syniachenko¹,

Golovach²,

Yehudіna³

2021

PJS

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“…Even a person diagnosed with PsA between the age of 18–40 years had a higher risk of surgery than a non-PsA 60+ year old after 15 years of follow-up. The 5-year IR of joint surgery in the Danish PsA population remained high opposed to a decrease in incidence in a Danish RA population in the bDMARD era 14…”

Section: Discussionmentioning

confidence: 91%

“…The introduction of biological DMARDS (bDMARDs) has had dramatic therapeutic effects and have demonstrated an ability to retard the radiological progression of peripheral arthritis; dactylitis, enthesitis and spondylitis 10–13. It is unclear if the introduction of bDMARDS has translated into a reduced need for joint surgery as observed in RA populations as it was introduced later and more gradually in PsA 14–16. Lewinson et al found a paradoxical increase in surgery following the introduction of bDMARDs in the UK 16.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2019

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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.

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“…Early detection of rheumatoid arthritis (RA) and early intervention with disease‐modifying antirheumatic drugs (DMARDs) significantly improve short‐ and long‐term therapeutic outcomes . Moreover, cardiovascular morbidity and the need for total joint replacement have significantly decreased since aggressive care for RA has become the norm . Maintaining tight control of disease activity for all RA patients requires frequent monitoring and adjusting medications to minimize inflammation .…”

Section: Introductionmentioning

confidence: 99%

Qualitative Exploration of Triangulated, Shared Decision‐Making in Rheumatoid Arthritis

Binder-Finnema

Dzurilla

Hsiao

et al. 2019

Arthritis Care & Research

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Objective. Treat-to-target implementation in rheumatoid arthritis (RA) requires a shared decision-making (SDM) process. However, ability to pay is a major determinant of patient choice, but how this factor affects SDM is underexplored.Methods. Visits at 4 RA clinics during which patients faced a decision to change their treatment were audiotaped between May 2016 and June 2017. Audiotapes were transcribed verbatim and analyzed using qualitative framework analysis.Results. A total of 156 visits were analyzed. Most patients with RA, except those with effective insurance coverage, had deliberations disrupted or sidelined by third-party insurance providers having power to authorize the preferred disease-modifying antirheumatic drug choice. This triangulated SDM complicated efficiency in deliberations and timely treatment and was a barrier to shared engagement about health risks and symptom improvement typically found in patient-provider dyads.Conclusion. Rheumatology care providers should aim to incorporate treatment costs and ability to pay into their deliberations so that individualized out-of-pocket estimates can be considered during triangulated SDM at the pointof-care.

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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

Cited by 55 publications

References 30 publications

Менеджмент Пацієнтів З Ревматоїдним Артритом У Періопераційному Періоді

Менеджмент Пацієнтів З Ревматоїдним Артритом У Періопераційному Періоді

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

Qualitative Exploration of Triangulated, Shared Decision‐Making in Rheumatoid Arthritis

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