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Open Access 01-12-2017 | Research article

Delayed anti-TNF therapy increases the risk of total knee replacement in patients with severe rheumatoid arthritis

Authors: Ying-Chou Chen, Wen-Chan Chiu, Tien-Tsai Cheng, Han-Ming Lai, Shan-Fu Yu, Ben Yu-Jih Su, Chung-Yuan Hsu, Chi-Hua Ko, Jia-Feng Chen

Published in: BMC Musculoskeletal Disorders | Issue 1/2017

Abstract

Background

This study evaluated the effect of early anti-tumor necrosis factor (TNF) therapy in patients with severe rheumatoid arthritis (RA) on the subsequent risk of total knee replacement (TKR) surgery.

Methods

This retrospective observational study included a hospital-based cohort of 200 patients diagnosed with severe RA who received treatment with anti-TNF therapy between 2003 and 2014. Clinical parameters including age, sex, body mass index, and the time from the diagnosis of RA to the initiation of anti-TNF therapy were analyzed.

Results

Of the 200 enrolled patients, 84 underwent an early intervention (≤3 years from the diagnosis of RA to the initiation of anti-TNF therapy), and 116 underwent a late intervention(>3 years from the diagnosis of RA to the initiation of anti-TNF therapy). Five (6.0%) patients in the early intervention group underwent TKR compared to 31 (26.7%) in the late intervention group (p = 0.023). After adjusting for confounding factors, the late intervention group still had a significantly higher risk of TKR (p = 0.004; odds ratio, 5.572; 95% confidence interval, 1.933–16.062). Those receiving treatment including methotrexate had a lower risk of TKR (p = 0.004; odds ratio, 0.287; 95% confidence interval, 0.122–0.672).

Conclusions

Delayed initiation of anti-TNF therapy in the treatment of severe RA was associated with an increased risk of TKR surgery. Adding methotrexate treatment decreased the risk of future TKR.

Harris ED Jr. Rheumatoid arthritis. Pathophysiology and implications for therapy. N Engl J Med. 1990;322(18):1277–89.CrossRefPubMed

Kraan MC, Reece RJ, Smeets TJ, Veale DJ, Emery P, Tak PP. Comparison of synovial tissues from the knee joints and the small joints of rheumatoid arthritis patients: Implications for pathogenesis and evaluation of treatment. Arthritis Rheum. 2002;46(8):2034–8.CrossRefPubMed

Mundinger A, Ioannidou M, Meske S, Dinkel E, Beck A, Sigmund G. MRI of knee arthritis in rheumatoid arthritis and spondylarthropathies. Rheumatol Int. 1991;11(4–5):183–6.CrossRefPubMed

Yamato M, Tamai K, Yamaguchi T, Ohno W. MRI of the knee in rheumatoid arthritis: Gd-DTPA perfusion dynamics. J Comput Assist Tomogr. 1993;17(5):781–5.CrossRefPubMed

Poleksic L, Musikic P, Zdravkovic D, Watt I, Bacic G. MRI evaluation of the knee in rheumatoid arthritis. Br J Rheumatol. 1996;35(Suppl 3):36–9.CrossRefPubMed

Wilson FC. Total replacement of the knee in rheumatoid arthritis. A prospective study of the results of treatment with the Walldius prosthesis. J Bone Joint Surg Am. 1972;54(7):1429–43.CrossRefPubMed

Wilson FC. Total replacement of the knee in rheumatoid arthritis. Part II. A prospective study. Clin Orthop Relat Res. 1973;94:58–64.CrossRef

Chand K. The knee joint in rheumatoid arthritis. III. Treatment by hinged total knee prosthetic replacement. Int Surg. 1974;59(11–12):600–7.PubMed

Chand K. The knee joint in rheumatoid arthritis. IV. Treatment by nonhinged total knee prosthetic replacement. Int Surg. 1975;60(1):11–8.PubMed

10.

Wolfe F, Hawley DJ. The longterm outcomes of rheumatoid arthritis: Work disability: a prospective 18 year study of 823 patients. J Rheumatol. 1998;25(11):2108–17.PubMed

11.

Jamsen E, Virta LJ, Hakala M, Kauppi MJ, Malmivaara A, Lehto MU. The decline in joint replacement surgery in rheumatoid arthritis is associated with a concomitant increase in the intensity of anti-rheumatic therapy: a nationwide register-based study from 1995 through 2010. Acta Orthop. 2013;84(4):331–7.CrossRefPubMedPubMedCentral

12.

Momohara S, Inoue E, Ikari K, Kawamura K, Tsukahara S, Iwamoto T, Hara M, Taniguchi A, Yamanaka H. Decrease in orthopaedic operations, including total joint replacements, in patients with rheumatoid arthritis between 2001 and 2007: data from Japanese outpatients in a single institute-based large observational cohort (IORRA). Ann Rheum Dis. 2010;69(1):312–3.CrossRefPubMed

13.

De Piano LP, Golmia RP, Scheinberg MA. Decreased need of large joint replacement in patients with rheumatoid arthritis in a specialized Brazilian center. Clin Rheumatol. 2011;30(4):549–50.CrossRefPubMed

14.

Nystad TW, Fenstad AM, Furnes O, Havelin LI, Skredderstuen AK, Fevang BT: Reduction in orthopaedic surgery in patients with rheumatoid arthritis: a Norwegian register-based study. Scand J Rheumatol. 2015:1–7.

15.

Koike T, Harigai M, Inokuma S, Ishiguro N, Ryu J, Takeuchi T, Tanaka Y, Yamanaka H, Fujii K, Yoshinaga T, et al. Postmarketing surveillance of safety and effectiveness of etanercept in Japanese patients with rheumatoid arthritis. Modern rheumatology / the Japan Rheumatism Association. 2011;21(4):343–51.CrossRef

16.

da Silva E, Doran MF, Crowson CS, O'Fallon WM, Matteson EL. Declining use of orthopedic surgery in patients with rheumatoid arthritis? Results of a long-term, population-based assessment. Arthritis Rheum. 2003;49(2):216–20.CrossRefPubMed

17.

Widdifield J, Moura CS, Wang Y, Abrahamowicz M, Paterson JM, Huang A, Beauchamp ME, Boire G, Fortin PR, Bessette L, et al. The Longterm Effect of Early Intensive Treatment of Seniors with Rheumatoid Arthritis: A Comparison of 2 Population-based Cohort Studies on Time to Joint Replacement Surgery. J Rheumatol. 2016;43(5):861–8.CrossRefPubMed

18.

Tada M, Koike T, Okano T, Sugioka Y, Wakitani S, Fukushima K, Sakawa A, Uehara K, Inui K, Nakamura H. Comparison of joint destruction between standard- and low-dose etanercept in rheumatoid arthritis from the Prevention of Cartilage Destruction by Etanercept (PRECEPT) study. Rheumatology (Oxford). 2012;51(12):2164–9.CrossRef

19.

Aaltonen KJ, Virkki LM, Jamsen E, Sokka T, Konttinen YT, Peltomaa R, Tuompo R, Yli-Kerttula T, Kortelainen S, Ahokas-Tuohinto P, et al. Do biologic drugs affect the need for and outcome of joint replacements in patients with rheumatoid arthritis? A register-based study. Semin Arthritis Rheum. 2013;43(1):55–62.CrossRefPubMed

20.

Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS, Healey LA, Kaplan SR, Liang MH, Luthra HS, et al. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum. 1988;31(3):315–24.CrossRefPubMed

21.

Moreland LW, Schiff MH, Baumgartner SW, Tindall EA, Fleischmann RM, Bulpitt KJ, Weaver AL, Keystone EC, Furst DE, Mease PJ, et al. Etanercept therapy in rheumatoid arthritis. A randomized, controlled trial. Ann Intern Med. 1999;130(6):478–86.CrossRefPubMed

22.

Bathon JM, Martin RW, Fleischmann RM, Tesser JR, Schiff MH, Keystone EC, Genovese MC, Wasko MC, Moreland LW, Weaver AL, et al. A comparison of etanercept and methotrexate in patients with early rheumatoid arthritis. N Engl J Med. 2000;343(22):1586–93.CrossRefPubMed

23.

Dohn UM, Skjodt H, Hetland ML, Vestergaard A, Moller JM, Knudsen LS, Ejbjerg BJ, Thomsen HS, Ostergaard M. No erosive progression revealed by MRI in rheumatoid arthritis patients treated with etanercept, even in patients with persistent MRI and clinical signs of joint inflammation. Clin Rheumatol. 2007;26(11):1857–61.CrossRefPubMed

24.

van der Heijde D, Klareskog L, Rodriguez-Valverde V, Codreanu C, Bolosiu H, Melo-Gomes J, Tornero-Molina J, Wajdula J, Pedersen R, Fatenejad S. Comparison of etanercept and methotrexate, alone and combined, in the treatment of rheumatoid arthritis: two-year clinical and radiographic results from the TEMPO study, a double-blind, randomized trial. Arthritis Rheum. 2006;54(4):1063–74.CrossRefPubMed

25.

Klareskog L, Gaubitz M, Rodriguez-Valverde V, Malaise M, Dougados M, Wajdula J. A long-term, open-label trial of the safety and efficacy of etanercept (Enbrel) in patients with rheumatoid arthritis not treated with other disease-modifying antirheumatic drugs. Ann Rheum Dis. 2006;65(12):1578–84.CrossRefPubMedPubMedCentral

Title: Delayed anti-TNF therapy increases the risk of total knee replacement in patients with severe rheumatoid arthritis
Authors: Ying-Chou Chen
Wen-Chan Chiu
Tien-Tsai Cheng
Han-Ming Lai
Shan-Fu Yu
Ben Yu-Jih Su
Chung-Yuan Hsu
Chi-Hua Ko
Jia-Feng Chen
Publication date: 01-12-2017
Publisher: BioMed Central
Published in: BMC Musculoskeletal Disorders / Issue 1/2017
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/s12891-017-1685-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Delayed anti-TNF therapy increases the risk of total knee replacement in patients with severe rheumatoid arthritis

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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