Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Arthritis Care Res (Hoboken). 2019 Nov;71(11):1525-1529. doi: 10.1002/acr.23793. Epub 2019 Oct 16.
Arthroplasty requirements among patients with psoriatic arthritis (PsA) are not well known. This information is important to clinical and policy stakeholders for health-system planning and may serve as a surrogate for estimation of the efficacy of disease-modifying therapy.
We utilized The Health Improvement Network (THIN), a large general practice medical records database in the UK, to assess rates of primary total arthroplasty among patients with PsA and the general population between the years 1995 and 2010. Linear regression was used to estimate arthroplasty rates for the 2 cohorts during the study period, and Poisson regression was used to determine age- and sex-adjusted incidence rate ratios (IRRs) between the PsA and general population cohorts.
We identified 5,619 patients with incident PsA and 5,090,814 eligible patients from the general population between 1995 and 2010. In total, 187 primary total arthroplasties were documented in patients with PsA, and 80,163 primary total arthroplasties were documented in the general population. A trend of increasing arthroplasty rates was observed for both the PsA (R = 0.809; P < 0.0001) and general population (R = 0.890; P < 0.0001) cohorts during the study period. After adjustment for age and sex, patients with PsA had a first arthroplasty incidence rate that was twice that of the general population (IRR 2.01 [95% confidence interval 1.73-2.34]; P < 0.0001), notably beyond the year 2003 when biologic therapies were introduced.
Both the general population and patients with PsA have experienced increasing rates of first arthroplasty from 1995 to 2010, although the overall incidence rate was significantly higher for those with PsA.
患有银屑病关节炎（PsA）的患者对关节置换的需求尚不清楚。这些信息对临床和政策利益相关者了解卫生系统规划非常重要，并且可以作为评估疾病修正治疗效果的替代指标。
我们利用英国大型全科医疗记录数据库 The Health Improvement Network（THIN），评估了 1995 年至 2010 年间患有 PsA 的患者和普通人群中初次全关节置换的发生率。使用线性回归估计研究期间两个队列的关节置换率，使用泊松回归确定 PsA 队列和普通人群队列之间的年龄和性别调整发病率比（IRR）。
我们在 1995 年至 2010 年间确定了 5619 例新诊断的 PsA 患者和 5090814 例符合条件的普通人群患者。共有 187 例 PsA 患者接受了初次全关节置换术，80163 例普通人群接受了初次全关节置换术。在研究期间，PsA（R=0.809；P<0.0001）和普通人群（R=0.890；P<0.0001）队列的关节置换率均呈上升趋势。在调整年龄和性别后，患有 PsA 的患者首次接受关节置换术的发生率是普通人群的两倍（IRR 2.01[95%置信区间 1.73-2.34]；P<0.0001），尤其是在 2003 年引入生物制剂后。
从 1995 年到 2010 年，普通人群和患有 PsA 的患者初次关节置换的发生率均有所增加，尽管患有 PsA 的患者的总体发病率明显更高。
