Study Finds Biologics Responsible for Reducing Total Joint Replacement Need in Rheumatoid Arthritis Patients

July 10, 2021 (Vancouver) – New research has revealed a significant reduction in the need for total hip and knee replacement surgery among rheumatoid arthritis patients after the introduction of biologics, which are medicines taken by IV or self-injection and are made up of large protein molecules derived from living cells. These drugs are used to treat chronic diseases such as rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, psoriasis, ulcerative colitis, Crohn’s Disease and cancer.

“These findings reflect a marked improvement in overall rheumatoid arthritis treatment since the introduction of biologics in the early 2000s,” said Hui Xie, a scientist at Arthritis Research Canada.

Researchers identified 60,227 rheumatoid arthritis and 288,260 osteoarthritis cases. For individuals diagnosed before the introduction of biologics, the 8-year incidence rates of total joint replacement surgery increased over time for both types of arthritis. For people diagnosed after biologics became available, these rates decreased over time in rheumatoid arthritis but continued to increase for osteoarthritis.

“We found a 26.9 per cent and 12.6 per cent reduction in total hip and knee replacements for patients with rheumatoid arthritis diagnosed five years after the introduction of biologics, in stark contrast with 11.7 per cent and 16.6 per cent increases for those procedures in osteoarthritis over the same time period,” said Vivienne Zhou, the first author of the paper and an MSc student trainee at Arthritis Research Canada.

Osteoarthritis is another condition for which total joint replacements are often required, and for which biologics are not used. This made osteoarthritis an ideal comparator group that had not been used in previous studies.

Rheumatoid arthritis, the most common type of inflammatory arthritis, affects approximately 1.2 per cent of Canadians aged 16 years and older. Uncontrolled inflammation causes irreversible joint damage which sometimes requires total joint replacement surgery.

Total joint replacements are effective at reducing pain and improving function, but they are expensive and complications can occur. Sometimes revision surgeries are also needed.

From 2019 to 2020, 63,496 hip replacements and 75,073 knee replacements were performed in Canada, costing more than $1.4 billion, according to the Canadian Institute for Health Information.

Biologics, such as tumor necrosis factor alpha inhibitors (TNF-α), are very effective at suppressing inflammation and can halt the progression of rheumatoid arthritis and prevent joint damage.

Prior to this study, there was conflicting evidence as to whether or not biologics reduced the need for total joint replacement surgery in rheumatoid arthritis patients. This study used large population-based cohorts of incident rheumatoid arthritis and osteoarthritis patients to document and compare the patterns of total joint replacement surgery over a 20-year period.

To learn more about this research study, click here.

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Arthritis Research Canada is the largest clinical arthritis research institution in North America. Our mission is to transform the lives of people living with arthritis through research and engagement. Arthritis Research Canada’s scientific director, Dr. Diane Lacaille is leading a team of over 100 researchers, trainees and staff whose world recognized research is creating a future where people living with arthritis are empowered to triumph over pain and disability. Arthritis Research Canada is conducting research across Canada in British Columbia, Alberta and Quebec and is affiliated with five major universities: University of British Columbia, Simon Fraser University, University of Calgary, Université Laval, and McGill University. Arthritis Research Canada is leading research aimed at arthritis prevention, early diagnosis, new and better treatment, and improved quality of life.

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