{"id":11562,"date":"2020-05-26T17:02:18","date_gmt":"2020-05-26T21:02:18","guid":{"rendered":"https:\/\/www.bumc.bu.edu\/im-residency\/?page_id=11562"},"modified":"2020-05-26T17:02:18","modified_gmt":"2020-05-26T21:02:18","slug":"relation-of-therapies-for-ankylosing-spondylitis-and-psoriatic-arthritis-to-risk-of-total-hip-and-knee-arthroplasty","status":"publish","type":"page","link":"https:\/\/www.bumc.bu.edu\/im-residency\/relation-of-therapies-for-ankylosing-spondylitis-and-psoriatic-arthritis-to-risk-of-total-hip-and-knee-arthroplasty\/","title":{"rendered":"Relation of Therapies for Ankylosing Spondylitis and Psoriatic Arthritis to Risk of Total Hip and Knee Arthroplasty"},"content":{"rendered":"

\"\"<\/p>\n

Rachael Stovall, MD<\/h3>\n

ABSTRACT<\/strong><\/p>\n

Objective:<\/strong> Ankylosing spondylitis and psoriatic arthritis (AS\/PsA) often affect the hip and\/or knee. If effective, treatments might reduce risk of total hip or total knee arthroplasty (THA\/TKA). We evaluated risk of THA\/TKA related to use of medical therapies in AS\/PsA.<\/p>\n

Methods:<\/strong> We conducted a nested case-control study using 1994-2018 data from the OptumLabs\u00ae Data Warehouse, which includes de-identified medical and pharmacy claims, laboratory results, and enrollment records for commercial and Medicare Advantage enrollees. Among those with AS\/PsA, THA\/TKA cases were matched to 4 controls by sex, age, AS\/PsA diagnosis, diagnosis year, insurance type, obesity and prior THA\/TKA. We assessed AS\/PsA treatment 6 months prior to THA\/TKA, including symptom-modifying anti-rheumatic drug (SMARD) and tumor necrosis factor inhibitor (TNFi), alone or in combination, stratified by NSAID use. We evaluated the relation of treatment to risk of THA\/TKA using conditional logistical regression with adjustment for confounders.<\/p>\n

Results:<\/strong> Among 16,748 adults with AS, there were 444 cases with THA\/TKA, and 1,613 matched controls. Among 34,512 adults with PsA, there were 1,003 cases and 3,793 controls. Adjusted odds ratios for treatment category and THA\/TKA ranged from 0.60 to 1.92, however none was statistically significant.\u00a0 Results were similarly null in several sensitivity analyses.<\/p>\n

Conclusions:<\/strong> Odds of THA\/TKA were not reduced with any combinations of NSAIDs, SMARD, or TNFi among persons with AS or PsA. Given current utilization patterns in this population of US adults with AS and PSA, these medical therapies did not appear to protect against end stage peripheral joint damage.<\/p>\n","protected":false},"excerpt":{"rendered":"

Rachael Stovall, MD ABSTRACT Objective: Ankylosing spondylitis and psoriatic arthritis (AS\/PsA) often affect the hip and\/or knee. If effective, treatments might reduce risk of total hip or total knee arthroplasty (THA\/TKA). We evaluated risk of THA\/TKA related to use of medical therapies in AS\/PsA. Methods: We conducted a nested case-control study using 1994-2018 data from […]<\/p>\n","protected":false},"author":15816,"featured_media":0,"parent":0,"menu_order":101,"comment_status":"open","ping_status":"closed","template":"page-templates\/no-sidebars.php","meta":[],"_links":{"self":[{"href":"https:\/\/www.bumc.bu.edu\/im-residency\/wp-json\/wp\/v2\/pages\/11562"}],"collection":[{"href":"https:\/\/www.bumc.bu.edu\/im-residency\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.bumc.bu.edu\/im-residency\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.bumc.bu.edu\/im-residency\/wp-json\/wp\/v2\/users\/15816"}],"replies":[{"embeddable":true,"href":"https:\/\/www.bumc.bu.edu\/im-residency\/wp-json\/wp\/v2\/comments?post=11562"}],"version-history":[{"count":1,"href":"https:\/\/www.bumc.bu.edu\/im-residency\/wp-json\/wp\/v2\/pages\/11562\/revisions"}],"predecessor-version":[{"id":11563,"href":"https:\/\/www.bumc.bu.edu\/im-residency\/wp-json\/wp\/v2\/pages\/11562\/revisions\/11563"}],"wp:attachment":[{"href":"https:\/\/www.bumc.bu.edu\/im-residency\/wp-json\/wp\/v2\/media?parent=11562"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}