Muscokeletal hospital admission and surgical procedure rates among patients treated for rheumatoid arthritis in the Netherlands

RA is a common chronic inflammatory joint disease. RA-related surgeries such as joint arthroplasty and other orthopaedic procedures are important outcomes over the course of the illness in terms of costs, physical function and quality of life. Recent studies show a milder disease course as compared with patients diagnosed earlier, a trend that accompanies the introduction of biological disease-modifying antirheumatic drugs (DMARD).

This study assessed trends in hospital admissions and musculoskeletal surgery among 32,829 patients treated for RA between 1999 and 2012, using the PHARMO Database Network. The hospital admission rate in 2012 was not different from the rate in 1999, but surgical procedure rates decreased steadily over the study years to less than half the rates in 1999. The largest reduction occurred among RA patients who used biological DMARDs, which was also the group with the highest surgery rates. Part of this trend must be explained by the effect of the biologicals itself, but may also reflect a trend towards earlier prescription of biologicals. Surgical procedure rates in 2012 remained higher among patients with RA than among non-RA reference subjects: over twice as high overall and almost four times higher among the subgroup of patients receiving biological DMARDs.

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