Evidence map›Paper›PMID 28764690›Full record

Observational studyBMC musculoskeletal disorders2017

Delayed anti-TNF therapy increases the risk of total knee replacement in patients with severe rheumatoid arthritis.

Ying-Chou Chen, Wen-Chan Chiu, Tien-Tsai Cheng, Han-Ming Lai, Shan-Fu Yu, Ben Yu-Jih Su, Chung-Yuan Hsu, Chi-Hua Ko, Jia-Feng Chen

Open access · goldAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMC musculoskeletal disorders, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.2field-weighted citation impact, top 41% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 4 citations in OpenAlex.

  1. Review
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 1 country.

Ying-Chou ChenDepartment of Rheumatology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, #123 Ta-Pei Road, Niao-Sung Dist, Kaohsiung, 833, Taiwan. r820713@ms13.hinet.net.
Wen-Chan ChiuDepartment of Rheumatology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, #123 Ta-Pei Road, Niao-Sung Dist, Kaohsiung, 833, Taiwan.
Tien-Tsai ChengDepartment of Rheumatology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, #123 Ta-Pei Road, Niao-Sung Dist, Kaohsiung, 833, Taiwan.
Han-Ming LaiDepartment of Rheumatology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, #123 Ta-Pei Road, Niao-Sung Dist, Kaohsiung, 833, Taiwan.
Shan-Fu YuDepartment of Rheumatology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, #123 Ta-Pei Road, Niao-Sung Dist, Kaohsiung, 833, Taiwan.
Ben Yu-Jih SuDepartment of Rheumatology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, #123 Ta-Pei Road, Niao-Sung Dist, Kaohsiung, 833, Taiwan.
Chung-Yuan HsuDepartment of Rheumatology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, #123 Ta-Pei Road, Niao-Sung Dist, Kaohsiung, 833, Taiwan.
Chi-Hua KoDepartment of Rheumatology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, #123 Ta-Pei Road, Niao-Sung Dist, Kaohsiung, 833, Taiwan.
Jia-Feng ChenDepartment of Rheumatology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, #123 Ta-Pei Road, Niao-Sung Dist, Kaohsiung, 833, Taiwan.
Kaohsiung Chang Gung Memorial Hospital · TWChang Gung University · TW

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThis study evaluated the effect of early anti-tumor necrosis factor (TNF) therapy in patients with severe rheumatoid arthritis (RA) on the subsequent risk of total knee replacement (TKR) surgery.

methodsThis retrospective observational study included a hospital-based cohort of 200 patients diagnosed with severe RA who received treatment with anti-TNF therapy between 2003 and 2014. Clinical parameters including age, sex, body mass index, and the time from the diagnosis of RA to the initiation of anti-TNF therapy were analyzed.

resultsOf the 200 enrolled patients, 84 underwent an early intervention (≤3 years from the diagnosis of RA to the initiation of anti-TNF therapy), and 116 underwent a late intervention(>3 years from the diagnosis of RA to the initiation of anti-TNF therapy). Five (6.0%) patients in the early intervention group underwent TKR compared to 31 (26.7%) in the late intervention group (p = 0.023). After adjusting for confounding factors, the late intervention group still had a significantly higher risk of TKR (p = 0.004; odds ratio, 5.572; 95% confidence interval, 1.933-16.062). Those receiving treatment including methotrexate had a lower risk of TKR (p = 0.004; odds ratio, 0.287; 95% confidence interval, 0.122-0.672).

conclusionsDelayed initiation of anti-TNF therapy in the treatment of severe RA was associated with an increased risk of TKR surgery. Adding methotrexate treatment decreased the risk of future TKR.

Indexed as

AdultAntirheumatic AgentsArthritis, RheumatoidArthroplasty, Replacement, KneeFemaleHumansMaleMethotrexateMiddle AgedRetrospective StudiesTumor Necrosis Factor-alphaAntirheumatic AgentsMethotrexateTumor Necrosis Factor-alphaAnti-TNF therapyDAS28Delayed interventionRARheumatoid arthritisTKRTotal knee replacement

Identifiers

PMID28764690
PMCPMC5540514
OpenAlexW2739642086

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.