In a nutshell
This study investigated if the timing of anti-tumor necrosis factor (TNF) therapy affected rates of knee replacement in patients with rheumatoid arthritis. They found that early intervention with anti-TNF therapy reduced the risk of total knee replacement (TKR) surgery.
Some background
Rheumatoid arthritis (RA) is a condition where the body’s immune system attacks the tissue in the joints. This causes irreparable damage and can lead to significant disability and chronic pain. In many cases, TKR surgery is necessary.
TNF is released in the body and is increases inflammation. In RA, TNF plays a major role in the degeneration of tissue and anti-TNF therapy can slow disease progression. However, whether anti-TNF therapy has an impact on the necessity for TKR surgery is unknown. In particular, it is not clear whether the timing of intervention with anti-TNF therapy has an impact on whether or not a patient will require TKR surgery.
Methods & findings
This was a retrospective study. The medical records of 200 patients with RA who received anti-TNF therapy were examined in this study. Patients were grouped according to the time of intervention relative to diagnosis: early (less than 3 years) and late (greater than 3 years).
5 early-intervention patients required TKR compared to 31 late-intervention patients. Overall, patients that underwent late intervention with anti-TNF therapy had a 5.57-fold higher risk of TKR surgery. Methotrexate (Trexall) treatment was associated with a 71% reduced risk of TKR.
The bottom line
This study concluded that early intervention with anti-TNF therapy reduces the risk of requiring TKR surgery in patients with RA.
The fine print
The sample size in this study was small and results may not translate to a larger population. Prolonged anti-TNF therapy may have safety issues so long-term studies are needed.
What’s next?
If you have any concerns regarding treatment please discuss this with your physician.
Published By :
BMC musculoskeletal disorders
Date :
Aug 02, 2017
