The decline in joint replacement surgery in rheumatoid arthritis is associated with a concomitant increase in the intensity of anti-rheumatic therapy
The decline in joint replacement surgery in rheumatoid arthritis is associated with a concomitant increase in the intensity of anti-rheumatic therapy
复制标题
类风湿关节炎关节置换手术的减少与抗风湿治疗强度的随之增加有关
作者：
E. Jämsen;L. Virta;M. Hakala;M. Kauppi;A. Malmivaara;M. Lehto
背景和目的 过去 20 年来，类风湿性关节炎 (RA) 的药物治疗取得了显着进展。利用全国登记数据，我们研究了 1995 年至 2010 年这对髋关节、膝关节、肩关节和肘关节置换率的影响。 方法 初次关节置换术的数量从芬兰关节置换术登记处获得。为了检验 RA 医疗治疗的改善减少关节置换需求的假设，我们还从全国药品登记处收集了不同疾病缓解抗风湿药 (DMARD) 和生物药品的购买数据。结果 RA 初次关节置换术的年发病率从 1995 年的每 105 例 19 例下降到 2010 年的每 105 例 11 例。上肢手术的下降幅度大于下肢手术。与此同时，使用甲氨蝶呤、羟氯喹和柳氮磺吡啶（最常用的 DMARD）的人数增加了 2 至 4 倍。解释 我们的结果与其他国家的观察结果一致，表明关节置换术在 RA 中的使用已大幅减少。我们的数据表明，有效的药物治疗是这一有利发展的最可能解释。
Background and purpose Drug-based treatment of rheumatoid arthritis (RA) has evolved markedly over the past 2 decades. Using nationwide register data, we studied how this has affected the rates of hip, knee, shoulder, and elbow replacement from 1995 to 2010. Methods The number of primary joint replacements was obtained from the Finnish Arthroplasty Register. To test the hypothesis that improvements in medical treatment of RA reduce the need for joint replacements, we also collected data about purchases of different disease-modifying anti-rheumatic agents (DMARDs) and biological drugs from the nationwide drug registers. Results The annual incidence of primary joint replacements for RA declined from 19 per 105 in 1995 to 11 per 105 in 2010. The decline was greater for upper-limb operations than for lower-limb operations. At the same time, the numbers of individuals using methotrexate, hydroxychloroquine, and sulfasalazine (the most commonly used DMARDs) increased 2- to 4-fold. Interpretation Our results are in accordance with observations from other countries, and indicate that the use of joint replacements in RA has decreased dramatically. Our data suggest that effective medical therapy is the most likely explanation for this favorable development.
影响因子：
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作者：
Fries, JF;Williams, CA;Sibley, J
通讯作者：
Sibley, J
影响因子：
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作者：
Fries,JF
通讯作者：
Fries,JF