Chang YS, Chen JH, Lin TM, et al. - Analyzing biologics efficacy in preventing total knee replacement (TKR) or total hip replacement (THR) in RA, it was found that relative to the csDMARD cohort, TKR and THR risks exhibited by the bDMARD cohort were same as those noted in the low to moderate dose subgroups and significantly lower in cases with regular bDMARD use.

• This retrospective nationwide study was conducted using the 2000–2013 claims-based National Health Insurance dataset.

• The biologic cohort was compared with age- and gender-matched csDMARD cohort, in terms of TKR and THR risks.

• Significantly lower incidence rates of TKR (11.73 vs 16.33/1000 person-years) and THR (7.09 vs 9.16/1000 person-years) were observed in the biologic cohort.

• Significantly lower risks of TKR (aHR: 0.55) and THR (aHR: 0.63) were noted in the regular bDMARD subgroup (average dose >0.95 defined daily dose/day), post-adjustment for confounding factors.

• The risks of TKR and THR were significantly higher in those without methotrexate use, with steroid use, with biologic switch, and overlapping antiphospholipid syndrome.