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SAT0333 Use of Glitazones and The Risk of Elective Hip Or Knee Replacement: A Population Based Case-Control Study
  1. J.T.H. Nielen1,2,
  2. B. van den Bemt3,4,
  3. A. Lalmohamed2,5,
  4. A. de Boer2,
  5. A. Boonen6,
  6. P.C. Dagnelie1,
  7. P. Emans7,
  8. F. de Vries2,8
  1. 1Department of Epidemiology, Maastricht University, Maastricht
  2. 2Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht University, Utrecht
  3. 3Department of Pharmacy, Radboud University Medical Center
  4. 4Department of Pharmacy, Sint Maartenskliniek, Nijmegen
  5. 5Department of Clinical Pharmacy, University Medical Center Utrecht, Utrecht
  6. 6Department of Rheumatology
  7. 7Department of Orthopaedics
  8. 8Departement of Clinical Pharmacy and Toxicology, Maastricht University Medical Center, Maastricht, Netherlands


Background Osteoarthritis (OA) is the most common musculoskeletal condition in the elderly population. However, to date, no disease modifying drug exists for this disease. In vivo studies have shown that glitazones may be used as anti-arthritic drugs. (Kobayashi, 2005; Boileau, 2007).

Objectives To determine the risk of total joint replacement (TJR) with the use of glitazones.

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 surgery between 2000 and 2012. Controls were matched by age, gender and general practice. Conditional logistic regression was used to estimate the risk of total knee (TKR) and total hip replacement (THR) associated with use of glitazones. We additionally evaluated risk of TJR in current glitazone users compared to DM patients using other antidiabetic drugs (ADs). In order to determine a dose effect relationship, we also stratified glitazone 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 glitazone users and patients not using glitazones. 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 glitazones users are compared to other AD users. Finally, we did not find a dose response effect with increasing number of prescriptions.

Conclusions This study did not find any evidence for an anti-arthritic effect of glitazones.


  1. Boileau et al. Arthritis and Rheumatism, 2007; Kobayashi et al. Arthritis & Rheumatism, 2005.

Disclosure of Interest J. Nielen: None declared, B. van den Bemt Grant/research support from: Pfizer, Roche, Speakers bureau: Pfizer, Roche, Abbvie and MSD, A. Lalmohamed Grant/research support from: Netherlands Organisation for Scientific Research (NWO), A. de Boer: None declared, A. Boonen Grant/research support from: Amgen Abbvie, Pfizer and Merck, Speakers bureau: Pfizer, UCB and Sandoz, P. Dagnelie: None declared, P. Emans Grant/research support from: Stryker, Active implants, Carbylan Biosurgery, DSM Biomedical, Regentis, Speakers bureau: Biomet and Push braces, F. de Vries: None declared

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