Effectiveness of Biological Treatment on Hip Involvement in Inflammatory Rheumatic Diseases

Hip involvement is a common presentation of chronic inflammatory rheumatic diseases. It profoundly affects patients' functional status and quality of life, reflecting a more severe disease. As the hip joint disease progresses, it can lead to severe disability. Arthroplasty is the most effective option for relieving pain and restoring function. Over the last few years, there has been a notable decrease in hip joint replacements, driven by satisfactory outcomes achieved with conservative strategies. This review summarizes the current evidence regarding the effect of available biological treatments on hip involvement in inflammatory rheumatic diseases. A narrative review was conducted using the PubMed database to identify case reports, case series, and original articles published up to 2024. TNFα inhibitors are effective in relieving hip involvement symptoms, maintaining satisfactory hip function, and stabilizing radiographic hip damage in patients with inflammatory rheumatic diseases. Tocilizumab seems to stop and reduce hip radiographic damage in patients with systemic juvenile idiopathic arthritis. IL-17/IL-23 axis inhibitors are effective in relieving hip pain in patients with spondyloarthritis, but their effect on hip structural damage remains unknown. Despite these promising findings, data regarding hip involvement remain scarce and limited to observational studies and case series.