ECTS Abstracts (2015) 1 P7

Use of thiazolidinediones and the risk of elective hip or knee replacement: a population based case-control study

Johannes Nielen1,5, Andrea Burden9,6, Bart van den Bemt2,3, Arief Lalmohamed1,8, Anthonius de Boer1, Annelies Boonen4, Pieter C Dagnelie5, Pieter Emans7 & Frank de Vries1,6


1Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht University, Utrecht, The Netherlands; 2Department of Pharmacy, Sint Maartenskliniek, Nijmegen, The Netherlands; 3Department of Pharmacy, Radboud University Medical Center, Nijmegen, The Netherlands; 4Department of Rheumatology, Maastricht University Medical Center, Maastricht, The Netherlands; 5Department of Epidemiology, Maastricht University, Maastricht, The Netherlands; 6Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Center, Maastricht, The Netherlands; 7Department of Orthopaedics, Maastricht University Medical Center, Maastricht, The Netherlands; 8Department of Clinical Pharmacy, University Medical Center Utrecht, Utrecht, The Netherlands; 9School Caphri, Maastricht University, Maastricht, The Netherlands.


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.