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Rheumatology International
Erschienen in: Rheumatology International 1/2012

01.01.2012 | Review Article

Should anti-TNF therapy be discontinued in rheumatoid arthritis patients undergoing elective orthopaedic surgery? A systematic review of the evidence

verfasst von: Leslie Goh, Teresa Jewell, Catherine Laversuch, Ash Samanta

Erschienen in: Rheumatology International | Ausgabe 1/2012

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Abstract

Anti-tumour necrosis factor (TNF) therapies have revolutionized the management of rheumatoid arthritis (RA). A high proportion of RA patients are now established users of anti-TNF agents. Unfortunately, many RA patients with longstanding disease still require elective orthopaedic procedures. Published studies on the influence of TNF antagonist on infection rates in RA patients undergoing surgery are conflicting. However, national registries of RA patients on anti-TNF reported an increased risk of infection. The risk of anti-TNF-related infection is highest at the start of treatment with frequent involvement of the skin and subcutaneous tissue. Infection at these sites could negatively influence the healing of surgical wound. Current guidelines suggest that treatment with biologics should be discontinued prior to surgery. Patients with established disease are more likely to flare compared to those with early disease on stopping treatment. Consequently, TNF blockers need to be reinstated promptly after surgery to avoid the risk of RA flare.
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Metadaten
Titel
Should anti-TNF therapy be discontinued in rheumatoid arthritis patients undergoing elective orthopaedic surgery? A systematic review of the evidence
verfasst von
Leslie Goh
Teresa Jewell
Catherine Laversuch
Ash Samanta
Publikationsdatum
01.01.2012
Verlag
Springer-Verlag
Erschienen in
Rheumatology International / Ausgabe 1/2012
Print ISSN: 0172-8172
Elektronische ISSN: 1437-160X
DOI
https://doi.org/10.1007/s00296-011-2040-6

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