Background: The aim was to determine the risk of total joint replacement (TJR) in patients using thiazolidinediones (TZDs) compared with those not using TZDs.
Methods: A population based case-control study was performed using the Clinical Practice Research Datalink (CPRD). Cases (n=94,609) were defined as patients >18 years of age who had undergone TJR between 2000 and 2012. Controls were matched by age, gender and general practitioner (GP) practice. Conditional logistic regression was used to estimate the risk of total knee (TKR) and total hip replacement (THR) associated with use of TZDs. We additionally evaluated risk of TJR in current TZD users compared with DM patients using other ADs. In order to determine a dose effect relationship, we also stratified TZD users by total number of prescriptions prior to surgery.
Results: There is no difference in risk of TKR (OR=1.11 [95% CI=0.95-1.29]) or THR (OR=0.87 [95% CI=0.74-1.02]) between TZD users and patients not using TZDs. Furthermore, there is no difference in risk of TKR (OR=1.03 [95% CI=0.88-1.22]) and THR (OR=0.90 [95% CI=0.75-1.08]) when TZD users are compared with other AD users. Finally, we did not find a dose response effect with increasing number of prescriptions.
Conclusion: Despite promising results from in vivo studies, this study did not find any evidence for an anti-arthritic effect of TZDs.
Disclosure: The authors declared no competing interests.