{"id":882,"date":"2019-10-10T11:48:35","date_gmt":"2019-10-10T11:48:35","guid":{"rendered":"https:\/\/blogs.bmj.com\/rheumsummaries\/?p=882"},"modified":"2020-05-28T11:50:11","modified_gmt":"2020-05-28T11:50:11","slug":"risk-of-joint-surgery-is-increased-in-people-with-psoriatic-arthritis","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/rheumsummaries\/2019\/10\/10\/risk-of-joint-surgery-is-increased-in-people-with-psoriatic-arthritis\/","title":{"rendered":"Risk of joint surgery is increased in people with psoriatic arthritis"},"content":{"rendered":"<p>Current treatments seem not to have reduced the long-term need for joint surgery in people with psoriatic arthritis.<\/p>\n<p><strong>Introduction<\/strong><br \/>\nPsoriatic arthritis (PsA for short) is a chronic inflammatory disease affecting a person\u2019s joints and other parts of the body, including the spine, skin, and tissues joining tendons and ligaments to bones (called entheses). It gets its name from the link between this type of arthritis and a skin condition called psoriasis, which causes red, flaky, crusty patches of skin covered with silvery scales. The inflammation in psoriatic arthritis often causes swelling of the fingers, toes or bigger joints (such as the knee). This can result in pain, fatigue, and mobility issues, among other symptoms. As a result, psoriatic arthritis can affect people\u2019s quality of life, which is a<br \/>\nmeasure of a person\u2019s physical, mental, emotional and social wellbeing.<\/p>\n<p>In time, many people with psoriatic arthritis will experience bone loss and breakdown (known as erosive arthritis), and joint surgery may be needed.<\/p>\n<p><span id=\"more-793\"><\/span><strong>What did the authors hope to find?<\/strong><br \/>\nThe authors hoped to show that medical treatment of people with psoriatic arthritis has reduced the need for joint replacement to the same level as the general population.<\/p>\n<p><strong>Who was studied?<\/strong><br \/>\nThe study included nearly 12,000 people with psoriatic arthritis in Denmark. The need for joint surgery in people with psoriatic arthritis was compared with people from the general population who were the same age, sex and lived in the same area. The average age of people in the study was 50 years, and 57% of those taking part were female.<\/p>\n<p><strong>How was the study conducted?<\/strong><br \/>\nThe authors used existing databases of patient records to look back and find people for each group. These databases were the Danish National Patient Registry and the Civil Registration System. Information from these databases meant they could work out the rates of joint surgery in both groups of people over a period from 1996 to 2017. There were no experimental treatments given.<\/p>\n<p><strong>What were the main findings of the study?<\/strong><br \/>\nThe study showed that the rate of joint surgery in people with psoriatic arthritis was twice as high as in the general population. It did not change much from 1996 to 2012.<\/p>\n<p>The study also showed that after 15 years of follow-up, 29% of the people with psoriatic arthritis needed joint surgery. Even relatively young people diagnosed with psoriatic arthritis between the ages of 18 to 40 years had a higher risk of needing joint surgery than someone over the age of 60 in the general population.<\/p>\n<p><strong>Are these findings new?<\/strong><br \/>\nYes, these findings are new, and they highlight an important issue for people with psoriatic arthritis. They also suggest that the need for joint surgery should be included as a measure in future studies of psoriatic arthritis.<\/p>\n<p><strong>What are the limitations of the study?<\/strong><br \/>\nThe study design did not allow the authors to take into account risk factors for surgery, such as osteoarthritis and fractures. In addition, they did not have access to information on people\u2019s body mass index, which can influence the need for joint surgery. However, the need for surgery in people with psoriatic arthritis compared to the general population in this study is somewhat greater. Even though the reason for surgery in some people may have been osteoarthritis, joint damage due to other kinds of inflammatory arthritis, or trauma, the high rates of joint surgery in people with psoriatic arthritis is an important issue.<\/p>\n<p><strong>What do the authors plan on doing with this information?<\/strong><br \/>\nThese results suggest that treatments have not reduced the need for joint replacement in people with psoriatic arthritis to the same level as the general population. The authors want to emphasise the need for an early medical treat-to-target strategy where the target, in this case, is no joint swelling, no inflammation in the finger and toe joints, or swollen tendons as signs of disease activity.<\/p>\n<p>This study did not split the results out by specific types of treatment that people had received. The authors are planning a new study to look at the impact of biological treatments on the need for joint surgery in people with psoriatic arthritis.<\/p>\n<p><strong>What does this mean for me?<\/strong><br \/>\nIf you have psoriatic arthritis, you are more at risk of needing joint surgery than someone of the same age without the disease. Future studies might help to show which treatments can reduce the risk.<\/p>\n<p>Staying well and healthy can help to protect your joints. This includes taking your treatment as prescribed, eating well, and taking appropriate exercise to strengthen and mobilise your joints.<\/p>\n<p>If you have any concerns about your disease or its treatment, you should talk to a healthcare professional.<\/p>\n<p><strong>Disclaimer:<\/strong>\u00a0This is a summary of a scientific article written by a medical professional (\u201cthe Original Article\u201d). The Summary is written to assist non medically trained readers to understand general points of the Original Article. It is supplied \u201cas is\u201d without any warranty. You should note that the Original Article (and Summary) may not be fully relevant nor accurate as medical science is constantly changing and errors can occur. It is therefore very important that readers not rely on the content in the Summary and consult their medical professionals for all aspects of their health care and only rely on the Summary if directed to do so by their medical professional. Please view our full\u00a0<a href=\"http:\/\/www.bmj.com\/company\/legal-information\/\">Website Terms and Conditions<\/a>.<\/p>\n<p>Date prepared: October 2019<br \/>\nSummary based on research article published on: 12 July 2019<br \/>\nFrom: Guldberg-M\u00f8ller J, et al. Incidence and time trends of joint surgery in patients with psoriatic arthritis: a register-based time series and cohort study from Denmark. Ann Rheum Dis 2019;78:1517\u20131523. doi:10.1136\/ annrheumdis-2019-215313<\/p>\n<p><strong>Copyright \u00a9<\/strong>\u00a02019 BMJ Publishing Group Ltd &amp; European League Against Rheumatism. Medical professionals may print copies for their and their patients and students non commercial use. Other individuals may print a single copy for their personal, non commercial use. For other uses please contact our\u00a0<a href=\"https:\/\/www.bmj.com\/company\/products-services\/rights-and-licensing\/\">Rights and Licensing Team<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Current treatments seem not to have reduced the long-term need for joint surgery in people with psoriatic arthritis. Introduction Psoriatic arthritis (PsA for short) is a chronic inflammatory disease affecting a person\u2019s joints and other parts of the body, including the spine, skin, and tissues joining tendons and ligaments to bones (called entheses). It gets [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/rheumsummaries\/2019\/10\/10\/risk-of-joint-surgery-is-increased-in-people-with-psoriatic-arthritis\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":384,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[8],"tags":[],"class_list":["post-882","post","type-post","status-publish","format-standard","hentry","category-psoriatic-arthritis"],"_links":{"self":[{"href":"https:\/\/blogs.bmj.com\/rheumsummaries\/wp-json\/wp\/v2\/posts\/882","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.bmj.com\/rheumsummaries\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.bmj.com\/rheumsummaries\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.bmj.com\/rheumsummaries\/wp-json\/wp\/v2\/users\/384"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.bmj.com\/rheumsummaries\/wp-json\/wp\/v2\/comments?post=882"}],"version-history":[{"count":0,"href":"https:\/\/blogs.bmj.com\/rheumsummaries\/wp-json\/wp\/v2\/posts\/882\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.bmj.com\/rheumsummaries\/wp-json\/wp\/v2\/media?parent=882"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.bmj.com\/rheumsummaries\/wp-json\/wp\/v2\/categories?post=882"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.bmj.com\/rheumsummaries\/wp-json\/wp\/v2\/tags?post=882"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}