Joint replacement rates declined more than half among RA patients
AMSTERDAM — Despite an increasing prevalence of rheumatoid arthritis, the rate of arthroplasty surgery declined by 51.9% among this patient population over a 13-year period, according to findings presented at the EULAR Annual Congress.
“We welcome these results demonstrating such a dramatic reduction of joint replacements in RA patients in recent years,” Robert B.M. Landewé, MD, PhD, professor of rheumatology at the University of Amsterdam, said in a press release. “It’s also very interesting to see data relating specifically to the impact of biological treatments on this outcome given the breadth of progress in the management of RA over the same time period.”
To evaluate the annual incidence of hip, knee and other arthroplasty surgeries among patients with RA, John Hanly, MD, FRCPC, director of the department of medicine research at Dalhousie University in Halifax, Nova Scotia, and colleagues evaluated data from approximately 1 million individuals between 1997 and 2010 using administrative health care data.
The researchers identified patients with RA using a previously validated RA case definition, and patients were matched by age and gender with four randomly selected controls to compare the annual frequency of arthroplasties between the two groups. Additionally, Hanly and colleagues examined the frequency of coronary artery interventions, including bypass grafting, angioplasty and stenting, between the two groups.
According to study results, although the prevalence of patients with RA increased from 3913 (0.42%) to 4911 (0.52%) over the course of the study, there was a significant reduction in arthroplasty surgery in patients with RA by 51.9% (P < 0.001). Among the control group, the frequency of procedures increased by 31.9% (P = .002), apart from hip arthroplasty rates, which decreased by 35% (P = .617) compared with 63% among patients with RA (P < .001).
“We found that there was a striking reduction in arthroplasty surgery among RA patients over 13 years of observation, which was not seen among the controls,” Hanly said during a press conference. “Surgery of all types was more frequent in RA patients than among any of the controls, and it increased over time for cardiac surgeries, but not for any of the arthroplasty surgeries.”
The researchers noted that although the frequency of cardiac procedures, which were higher among patients with RA in both the first (P = .013) and last (P = .003) years of observation, increased in both patients and controls over time, it did not achieve statistical significance in either group.
“During the same time period, there were sustained rates of cardiac procedures, which suggests that it was not a problem of access that was causing this decrease in arthroplasty surgery,” Hanly said. “We suggest that early diagnosis and improved medical therapy over the last few decades were likely responsible for this decline.” – by Bob Stott
Hanly JG, et al. Abstract #SAT0077. EULAR Annual Congress; June 13-17, 2018; Amsterdam.
Disclosure: Hanly reports no relevant financial disclosures. Please see the studies for all other authors’ relevant financial disclosures.