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RA patients should seek treatment on time as delayed anti-TNF therapy has been found to significantly increase the risk of total knee replacement surgery in RA patients.
Rheumatoid arthritis (RA) patients can have substantial long-term consequences. One 18-year longitudinal study published in 1998 determined that 25% of all patients with RA required total joint replacement surgery. Severe rheumatoid arthritis study assesses the effect of early anti-tumour necrosis factor (TNF) therapy in patients with severe rheumatoid arthritis (RA) on the successive risk of total knee replacement (TKR) surgery.
This retrospective experimental study involved a hospital-based cohort of 200 patients recognised with severe RA who received therapy with anti-TNF therapy between 2003 and 2014. Sex, age, BMI, and the time from the diagnosis of RA to the initiation of anti-TNF treatment were analysed. 84 patients underwent an early intervention (≤3 years from the diagnosis of RA to the initiation of anti-TNF treatment), and 116 underwent a late intervention(>3 years from the diagnosis of RA to the commencement of anti-TNF treatment). Five (6.0%) patients in the prior intervention group underwent TKR differentiate to 31 (26.7%) in the late intervention group (p = 0.023). After modifying for confounding aspect, the late intervention group still had a consequently higher risk of TKR (p = 0.004; odds ratio, 5.572; 95% confidence interval, 1.933–16.062). Those undergo therapy involved methotrexate had lower chances of TKR (p = 0.004; odds ratio, 0.287; 95% confidence interval, 0.122–0.672).
Delayed commencement of anti-TNF therapy in the treatment of severe RA was related to an increased risk of TKR surgery. Adding methotrexate treatment reduced the risk of future TKR.
BMC Musculoskeletal Disorders
Delayed anti-TNF therapy increases the risk of total knee replacement in patients with severe rheumatoid arthritis
Ying-Chou C. et al.
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