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A time-series analysis of incident rheumatoid arthritis (RA) patients seen between 1996 and 2011 in the Danish National Patient Register shows that the incidence of hip (THR) and knee replacements (TKR) began to decrease after the introdution of biologic agents for RA in 2002.
RA patents were matched (age, sex, geography) 1:10 with general population comparators (GPCs). Standardized 5-year incidence rates of THR and TKR surgery were reported from 1996–2001 and compared with the bDMARD era (2003–2016) after the 2002 Danish guidelines introduced biologics for use in RA.
They compared THR and TKR rates between 30 404 RA patients and 297916 GPCs.
Among patients with RA, the incidence rate of TKR increased from 1996 to 2001, but started to decrease from 2003 and throughout the bDMARD era. The incidence of TKR increased among GPCs from 1996 to 2016.
Knee replacement Rates in RA 1996-2012
In 1996, the incidence rate of THR and TKR was 3-fold and 14-fold higher, respectively among patients with RA compared with GPCs in 1996. The introduction of biologics resulted in decreasing TKR rates.
The incidence of THR had started to decrease before bDMARD introduction in 2003.