Number of Joint Replacements Drop in Rheumatoid Arthritis Patients Interview with:

Hip Replacement NIH Image

Hip Replacement
NIH Image

Samuel Hawley | Research Assistant (NIHR PhD Project) |
Pharmaco- and Device Epidemiology Group |
Centre for Statistics in Medicine | NDORMS |
University of Oxford What is the background for this study? What are the main findings?

Response: The aim was to disentangle some of the potential reasons for the recent decline in joint replacement rates among rheumatoid arthritis (RA) patients in the developed world.

The main findings from our UK patient-level analysis indicated that joint replacement rates were not significantly different for users of TNF inhibitors versus the patients who remained only on conventional synthetic DMARDS, however we did find that TNF inhibitor use amongst older RA patients was associated with a 40% reduction in hip replacement rates. What should readers take away from your report?

Response: Given the significantly lower rates of hip replacement observed among older RA patients on a TNF inhibitor, it would seem biologic therapies have a role to play in the reduction of joint replacement rates in rheumatoid arthritis, however the lack of an association overall and at other joints also highlights the need to consider other explanations for the stark trends of declining joint replacement rates for RA patients throughout the developed world. What recommendations do you have for future research as a result of this work?

Response: Exploring the effect of therapy duration would be interesting and we definitely welcome the repetition our analyses using datasets from other countries in different health care settings from that of our own study.

Disclosures: I would like to thank all co-authors of the study, notably Dr Daniel Prieto-Alhambra who supervised the investigation and is funding by an NIHR Clinician Scientist Award.

I do not have any disclosures, although those of my co-authors can be found listed as part of the EULAR conference abstract. 


Impact of tnf inhibitors on need for joint replacement in patients with rheumatoid arthritis: a matched cohort analysis of uk biologics registry data
EULAR 2018
Biologics in RA. Improving and maintaining the response

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