Pharmacoeconomic analysis of biologics and methotrexate for rheumatoid arthritis from the standpoint of the number needed to treat concept under the Japanese health insurance system.

Objectives: To evaluate the cost-effectiveness of biologics and methotrexate (MTX) for rheumatoid arthritis (RA) using the number needed to treat (NNT) concept and total actual health care cost.

Methods: This study included 121 RA patients with newly prescribed biologics and/or MTX between 2012 and 2017. The NNT was calculated based on the 24 week remission rate of Disease Activity Score in 28 joints using erythrocyte sedimentation rate (DAS28-ESR) and Clinical Disease Activity Index (CDAI).

Risk Factors Associated with Aggravation of Cervical Spine Lesions in Patients with Rheumatoid Arthritis: A Retrospective Longitudinal Cohort Study.

Study Design: A retrospective cohort study.

Objective: To examine factors related to severe aggravation of preexisting cervical lesions in patients with rheumatoid arthritis (RA) under current pharmacologic treatments with biologics.

Summary Of Background Data: Advanced RA cervical lesions carry a risk of irreversible damage to the spinal cord; however, risk factors for aggravation are unclear after the use of biologics became more popular.

Risk factors associated with cervical spine lesions in patients with rheumatoid arthritis: an observational study.

Background: Few reports have described the association between rheumatoid arthritis (RA) cervical lesions and osteoporosis, especially in patients with vertical subluxation (VS) that could be induced by the collapse of lateral masses in the upper cervical spine. Therefore, this study aimed to investigate the prevalence and risk factors for cervical lesions in patients with RA under current pharmacological treatments with biological agents, and to investigate the relationship between osteoporosis and VS development.

Methods: One hundred eighty-five consecutive patients with RA who underwent both cervical plain radiography and bone mineral density (BMD) scanning were enrolled.

Factors associated with disease activity after orthopaedic surgery in patients with rheumatoid arthritis.

This study evaluated the effect of surgical intervention on disease activity and factors associated with postoperative disease activity in patients with rheumatoid arthritis (RA). One hundred and seventy-five patients with RA who underwent a single orthopaedic surgical procedure with 1 year of follow-up were retrospectively reviewed to assess postoperative changes in disease activity using disease activity score in 28 Joints calculated with C-reactive protein (DAS28-CRP). European League against Rheumatology (EULAR) response criteria were used to assess the response to surgical intervention.

Does Abatacept Increase Postoperative Adverse Events in Rheumatoid Arthritis Compared with Conventional Synthetic Disease-modifying Drugs?

Objective: To investigate whether abatacept (ABA) causes more adverse events (AE) than conventional synthetic disease-modifying antirheumatic drugs (csDMARD) after orthopedic surgery in patients with rheumatoid arthritis (RA).

Methods: A retrospective multicenter nested case-control study was performed in 18 institutions. Patients receiving ABA (ABA group) were matched individually with patients receiving csDMARD and/or steroids (control group).

In Asian women undergoing total knee arthroplasty, lower leg morphology in those with rheumatoid arthritis differed from those with osteoarthritis.

This retrospective, single-center study aimed to compare leg morphology between patients with rheumatoid arthritis (RA) and those with osteoarthritis (OA) undergoing total knee arthroplasty (TKA). We enrolled 70 RA and 327 OA female patients undergoing TKA. Hip-knee-ankle angle (HKA), femorotibial angle (FTA), valgus correction angle (VCA), and femoral/tibial bowing were measured using full-length radiographs.

Effects of forefoot arthroplasty on plantar pressure, pain, gait and disability in rheumatoid arthritis.

The purpose of this study was to clarify the effect of forefoot arthroplasty on plantar pressure, pain, gait, and disability within 1 year after arthroplasty in patients with RA. Eleven patients with RA who underwent forefoot arthroplasty completed this quasi-experimental study. Outcome measures were in-shoe plantar pressure, visual analog scale (VAS) for pain, temporal gait parameters, and modified Health Assessment Questionnaire (mHAQ), obtained preoperatively and at 4 and 12 months postoperatively.

Mid- term results of stryker® scorpio plus mobile bearing total knee arthroplasty.

Background: The mobile bearing knee system was introduced to lessen contact stress on the articular bearing surface and reduce polyethylene wear. The purpose of the current study was to investigate the mid-term results of patients undergoing total knee arthroplasties (TKAs) using Scorpio Plus Mobile Bearing Knee System (Stryker, Mahwah, NJ), and compare the outcomes between patients with osteoarthritis and osteonecrosis (OA·ON group) and patients with rheumatoid arthritis (RA group).

Methods: Eight males and 58 females were followed up for a period of 4.

Good long-term outcome of synovectomy in advanced stages of the rheumatoid elbow.

Background And Purpose: Synovectomy is an effective procedure for management of the rheumatoid elbow at radiographically early stages (Larsen grades 1 and 2). However, its efficacy for advanced stages (Larsen grades 3-5) is controversial. We investigated the outcome of synovectomy for advanced stages of the rheumatoid elbow.

Clinical and radiographic evaluation of total hip arthroplasties using porous tantalum modular acetabular components: 5-year follow-up of clinical trial.

Objectives: Porous tantalum is a biomaterial newly applied for artificial joints. We present here 5-years follow-up report of a multicenter clinical trial of total hip arthroplasties (THA) with porous tantalum modular acetabular component (modular PTC).

Methods: Study participants received 82 hips in 79 cases, with 61.

Change in pelvic tilt angle 2 to 4 years after total hip arthroplasty.

The purpose of this study was to evaluate the change in pelvic tilt angle (PA) in the sagittal plane in the standing and supine positions for 2 to 4 years after total hip arthroplasty (THA). Anteroposterior pelvic radiographs of 21 male and 65 female patients were investigated before and after THA yearly over 2 to 4 years. Both the standing and supine PA significantly posteriorly tilted after THA.

Risk of postoperative complications in rheumatoid arthritis relevant to treatment with biologic agents: a report from the Committee on Arthritis of the Japanese Orthopaedic Association.

Purpose: Since biologic agents were introduced to treat rheumatoid arthritis (RA) in 2003, the number of orthopedic surgical procedures under treatment with biologic agents has been increasing in Japan. However, whether biologic agents cause an increase in the prevalence of postoperative complications is as yet unknown. The Committee on Arthritis of the Japanese Orthopedic Association investigated the prevalence of postoperative complications in patients with RA in teaching hospitals in Japan.

Clinical and radiological results of GSB III total elbow arthroplasty in patients with rheumatoid arthritis.

Total elbow arthroplasty (TEA) with the GSB III prosthesis was performed in 32 patients (36 elbows) with rheumatoid arthritis between 2001 and 2009. At final follow-up, 31 patients (35 TEAs) were available for clinical and radiological evaluation. The mean follow-up period was 6.

Dystrophic calcinosis in a patient with rheumatoid arthritis.

We report a rare case of dystrophic calcinosis in a patient with rheumatoid arthritis in bilateral buttock lesions and the right elbow joint. The calcinosis was surgically removed because it caused severe local pain, possible infection, and difficulty in sitting. Because no recommended standard pharmacotherapy exists for dystrophic calcinosis, surgical treatment should be taken into consideration when calcinosis causes severe local pain or restricts activities of daily life.

Primary cervical epidural malignant lymphoma with rheumatoid arthritis: a case report.

We report a case of primary cervical epidural malignant lymphoma with rheumatoid arthritis. Because of the acute progression of paralysis in both legs, surgical decompression and stabilization of the cervical spine were performed. The resected specimen showed proliferation of lymphoblastic cells diagnosed as malignant lymphoma.

Clinical and radiological results of non-cement impaction bone-graft method of total hip arthroplasty for rheumatoid arthritis.

We performed total hip arthroplasty using the non-cement impaction auto-bone-grafting method with the resected femoral head for acetabular protrusion that is not combined with the destruction of acetabular rim or dysplasia of the hip joint. Ten patients (eight women and two men) with rheumatoid arthritis who showed acetabular protrusion underwent total hip arthroplasty using this method. All patients were able to walk with full weight within 5 days after surgery.

Alendronate does not inhibit early bone apposition to hydroxyapatite-coated total joint implants: a preliminary study.

Background: Alendronate is a pyrophosphate analogue of bisphosphonate that has been shown to inhibit osteoclastic bone resorption. Bone formation and remodeling are necessary to establish initial fixation of uncemented implants, especially those coated with a bioactive surface such as hydroxyapatite. Because the process of bone-remodeling that culminates in new-bone formation is thought to be initiated by osteoclastic bone resorption, it is appropriate to test the influence of osteoclast-inhibiting medications on bone apposition to hydroxyapatite-coated implants.

Histologic and quantitative wear particle analyses of tissue around cementless ceramic total knee prostheses.

We histologically analyzed tissue biopsy specimens obtained from 4 cases of revised cementless ceramic knee prostheses. Particles were isolated from the specimens, and their size and composition were determined. Implants were removed for aseptic loosening at an average of 64 months.

The effect of particle wear debris on NFkappaB activation and pro-inflammatory cytokine release in differentiated THP-1 cells.

Orthopedic wear debris has been thought to be an important factor associated with osteolysis and loosening of total joint arthroplasties. Previous in vitro studies have reported that particles of wear debris induce the release of pro-inflammatory cytokines and other inflammatory mediators from macrophages and other cells. Several recent investigations, however, have suggested that the wear particles themselves may not be primarily responsible for the inflammatory cellular responses, but that the observed cytokine release in vitro may be caused by endotoxin adsorbed to commercially available particle preparations.