As per the findings of a nested case-control study, the odds of total hip arthroplasty/ total knee arthroplasty (THA/TKA) were not reduced using any combinations of tumor necrosis factor inhibitors (TNFi), nonsteroidal anti-inflammatory drugs (NSAIDs), or disease-modifying antirheumatic drugs (DMARDs) in people having ankylosing spondylitis (AS) or psoriatic arthritis (PsA).

Rachael Stovall et al. investigated the risk of THA/TKA associated with the usage of medical therapies in PsA/AS. In this, the data used included de-identified pharmacy and medical claims, lab findings, and recruitment records for commercial and medicare advantage enrollees.

In patients having PsA/AS, THA/TKA cases were matched up to four controls by gender, age, PsA/AS diagnosis, obesity, diagnosis year, previous THA/TKA, and insurance type. PsA/AS therapy was evaluated six months before THA/TKA, including DMARDs and TNFi, alone or in combination, stratified by the usage of NSAID.

With the aid of conditional logistical regression, the relation of therapy to the risk of THA/TKA was evaluated. In 16,748 adult people suffering from AS, there were 1613 matched controls and 444 THA/TKA cases. In 34,512 adult people suffering from PsA, there were 3793 controls and  1003 cases.

The adjusted odds ratio for treatment category and THA/TKA was found to range from 0.60 to 1.92. But, none were statistically significant. Notably, the findings were similarly null in numerous sensitivity analyses. Considering current utilization patterns in people with PsA and AS, these medical therapies did not seem to improve end-stage peripheral joint damage, concluded the study authors.