Joint surgery in the Utrecht Rheumatoid Arthritis Cohort: The effect of treatment strategy

S. M M Verstappen, J. N. Hoes, E. J. Ter Borg, J. W J Bijlsma, A. A M Blaauw, G. A. Van Ajbada-Kuipers, C. Van Booma-Frankfort, J. W G Jacobs

    Research output: Contribution to journalArticlepeer-review


    Objective: To investigate the prevalence and prognostic factors of joint surgery in a large cohort of patients with rheumatoid arthritis, whose treatment, clinical and radiographic data have been assessed at predefined points in time since disease onset. Methods: Data on surgical interventions were retrospectively obtained from 482 patients with rheumatoid arthritis whose follow-up data for at least 2 years were available, including treatment and response to treatment during the first 2 years. Survival time until the first surgical intervention and until the first major surgical intervention was determined for the total study population by Kaplan-Meier survival curves. Three separate Cox regression analyses were carried out to determine which variables measured at baseline, during the first year and during the first 2 years were predictors for joint surgery. Results: 27% of the patients underwent surgical interventions. Mean survival time until the first surgical intervention was 10.4 years. The percentage of patients with a surgical intervention was 10% lower in the group with response to treatment when compared with the non-response group. Next to a delayed start with disease-modifying antirheumatic drugs, fast radiographic progression during the first year and first 2 years was a predictor of joint surgery in the multivariate regression analyses. Conclusion: Treatment with disease-modifying antirheumatic drugs immediately after diagnosis results in less joint surgery when compared with a delayed start. Furthermore, joint surgery is carried out more often in patients who do not respond to treatment.
    Original languageEnglish
    Pages (from-to)1506-1511
    Number of pages5
    JournalAnnals of the rheumatic diseases
    Issue number11
    Publication statusPublished - Nov 2006


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