Takumi Matsumoto1,2, Jinju Nishino3,4, Naohiro Izawa3,4, Masashi Naito3,4, Jun Hirose3,4, Sakae Tanaka3,4, Testuro Yasui3,4, Koichiro Saisho3,4, Shigeto Tohma3,4. 1. From the Department of Orthopedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo; Department of Rheumatology, Miyakonojo Medical Center, National Hospital Organization, Miyazaki; Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, National Hospital Organization, Sagamihara, Japan. matumot-tky@umin.ac.jp. 2. T. Matsumoto, MD, PhD, Department of Orthopedic Surgery, Faculty of Medicine, The University of Tokyo; J. Nishino, MD, Department of Orthopedic Surgery, Faculty of Medicine, The University of Tokyo; N. Izawa, MD, Department of Orthopedic Surgery, Faculty of Medicine, The University of Tokyo; M. Naito, MD, Department of Orthopedic Surgery, Faculty of Medicine, The University of Tokyo; J. Hirose, MD, PhD, Department of Orthopedic Surgery, Faculty of Medicine, The University of Tokyo; S. Tanaka, MD, PhD, Department of Orthopedic Surgery, Faculty of Medicine, The University of Tokyo; T. Yasui, MD, PhD, Department of Orthopedic Surgery, Teikyo University Mizonokuchi Hospital; K. Saisho, MD, PhD, Department of Rheumatology, Miyakonojo Medical Center, National Hospital Organization; S. Tohma, MD, PhD, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, National Hospital Organization. matumot-tky@umin.ac.jp. 3. From the Department of Orthopedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo; Department of Rheumatology, Miyakonojo Medical Center, National Hospital Organization, Miyazaki; Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, National Hospital Organization, Sagamihara, Japan. 4. T. Matsumoto, MD, PhD, Department of Orthopedic Surgery, Faculty of Medicine, The University of Tokyo; J. Nishino, MD, Department of Orthopedic Surgery, Faculty of Medicine, The University of Tokyo; N. Izawa, MD, Department of Orthopedic Surgery, Faculty of Medicine, The University of Tokyo; M. Naito, MD, Department of Orthopedic Surgery, Faculty of Medicine, The University of Tokyo; J. Hirose, MD, PhD, Department of Orthopedic Surgery, Faculty of Medicine, The University of Tokyo; S. Tanaka, MD, PhD, Department of Orthopedic Surgery, Faculty of Medicine, The University of Tokyo; T. Yasui, MD, PhD, Department of Orthopedic Surgery, Teikyo University Mizonokuchi Hospital; K. Saisho, MD, PhD, Department of Rheumatology, Miyakonojo Medical Center, National Hospital Organization; S. Tohma, MD, PhD, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, National Hospital Organization.
Abstract
OBJECTIVE: In this study, we investigated the changes in clinical outcome, treatment, and incidence of orthopedic surgery in patients with rheumatoid arthritis (RA) from 2004 to 2014. METHODS: Data were studied from the Japanese nationwide cohort database, NinJa (National Database of Rheumatic Diseases by iR-net in Japan), from 2004 to 2014. The time trends in the incidence of orthopedic procedures were analyzed using linear regression analysis. The cross-sectional annual data were compared between 2004 and 2014 to analyze the changes in clinical outcome and treatment. RESULTS: The incidence of orthopedic surgeries in patients with RA consistently decreased from 72.2 procedures per 1000 patients in 2004 to 51.5 procedures per 1000 patients in 2014 (regression coefficient = -0.0028, 95% CI -0.0038 to -0.0019, p < 0.001). The greatest reduction was found in total knee arthroplasty and total hip arthroplasty. Disease activity and functional disability improved significantly over this decade. The proportions of patients receiving methotrexate and biologic disease-modifying antirheumatic drugs significantly increased from 39.6% and 1.7% in 2004 to 63.8% and 27.4% in 2014, respectively. CONCLUSION: The overall incidence of orthopedic surgeries in patients with RA significantly decreased, accompanied by improved clinical outcomes because of the expanded use of effective drugs; however, the declining trend differed between procedures or locations. The results from the present study suggest that there might be a change in supply and demand for orthopedic surgeries.
OBJECTIVE: In this study, we investigated the changes in clinical outcome, treatment, and incidence of orthopedic surgery in patients with rheumatoid arthritis (RA) from 2004 to 2014. METHODS: Data were studied from the Japanese nationwide cohort database, NinJa (National Database of Rheumatic Diseases by iR-net in Japan), from 2004 to 2014. The time trends in the incidence of orthopedic procedures were analyzed using linear regression analysis. The cross-sectional annual data were compared between 2004 and 2014 to analyze the changes in clinical outcome and treatment. RESULTS: The incidence of orthopedic surgeries in patients with RA consistently decreased from 72.2 procedures per 1000 patients in 2004 to 51.5 procedures per 1000 patients in 2014 (regression coefficient = -0.0028, 95% CI -0.0038 to -0.0019, p < 0.001). The greatest reduction was found in total knee arthroplasty and total hip arthroplasty. Disease activity and functional disability improved significantly over this decade. The proportions of patients receiving methotrexate and biologic disease-modifying antirheumatic drugs significantly increased from 39.6% and 1.7% in 2004 to 63.8% and 27.4% in 2014, respectively. CONCLUSION: The overall incidence of orthopedic surgeries in patients with RA significantly decreased, accompanied by improved clinical outcomes because of the expanded use of effective drugs; however, the declining trend differed between procedures or locations. The results from the present study suggest that there might be a change in supply and demand for orthopedic surgeries.
Entities:
Keywords:
DISEASE ACTIVITY; EPIDEMIOLOGY; RHEUMATOID ARTHRITIS; SURGERY
Authors: Katinka Albrecht; Denis Poddubnyy; Jan Leipe; Philipp Sewerin; Christof Iking-Konert; Roger Scholz; Klaus Krüger Journal: Z Rheumatol Date: 2022-03-02 Impact factor: 1.372
Authors: Katinka Albrecht; Denis Poddubnyy; Jan Leipe; Philipp Sewerin; Christof Iking-Konert; Roger Scholz; Klaus Krüger Journal: Z Rheumatol Date: 2021-12-20 Impact factor: 1.372