Incidence and time trends of joint surgery in patients with psoriatic arthritis: a register-based time series and cohort study from Denmark. Issue 11 (12th July 2019)

• Record Type: Journal Article
• Authors: Guldberg-Møller, Jørgen; Cordtz, Rene Lindholm; Kristensen, Lars Erik; Dreyer, Lene
• Is Part Of: Annals of the rheumatic diseases. Volume 78:Issue 11(2019)
• Page Start: 1517
• Page End: 1523
• Publication Date: 2019-07-12
• Subjects: psoriatic arthritis -- orthopaedic surgery -- DMARDS (biologic) -- epidemiology; Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2019-215313
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Objective: To investigate time-trends and cumulative incidence of joint surgery among patients with psoriatic arthritis (PsA) compared with the general population. Methods: In this nationwide register-based cohort study, The Danish National Patient Registry was used to identify incident PsA patients. The 5-year incidence rates (IR) and incidence rate ratios (IRR) of joint surgery were calculated in four calendar-period defined cohorts. Each patient was matched with ten non-PsA individuals from the general population cohort (GPC). The cumulative incidences of any joint and joint-sacrificing surgery, respectively, were estimated using the Aalen-Johansen method. Results: From 1996 to 2017, 11 960 PsA patients (mean age 50 years; 57% female) were registered. The IRR of any joint surgery was twice as high for PsA patients compared with GPCs across all calendar periods. Among patients with PsA, 2, 10 and 29% required joint surgery at 5, 10 and 15 years after diagnosis. The risk of surgery in PsA patients diagnosed at 18–40 years was higher (22%) than in GPC 60+ year old (20%) after 15 years of follow-up. Conclusions: The use of joint surgery among PsA patients remained around twofold higher from 1996 to 2012 compared with GPC. After 15 years of follow-up, nearly 30% of the PsA patients had received any surgery, and even a person diagnosed with PsA at the age of 18–40 years had a higher risk of surgery than GPCs of 60+ year old. Thus, the high surgical rates represent an unmet need in the current treatment of PsA.