The impact of bDMARDs on postoperative complications in patients with rheumatoid arthritis: A systematic review and meta-analysis

Author:

Suto Takahito1,Okamura Koichi1,Sakane Hideo12,Okura Chisa13,Kaneko Tetsuya14,Chikuda Hirotaka1

Affiliation:

1. Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan

2. Department of Orthopaedic Surgery, Fujioka General Hospital, Fujioka, Gunma, Japan

3. Department of Orthopaedic Surgery, Gunma Saiseikai Maebashi Hospital, Maebaashi, Gunma, Japan

4. Department of Orthopaedic Surgery, Japan Redcross Society Fukaya Redcross Hospital, Fukaya, Saitama, Japan.

Abstract

Background: The influence of biological disease-modifying antirheumatic drugs (bDMARDs) on postoperative surgical site infection (SSI) and venous thromboembolism (VTE) in patients with rheumatoid arthritis (RA) has not yet been clarified. Methods: A systematic literature search was performed using PubMed, Web of ScienceTM, Scopus, and The Cochrane Library databases to identify eligible studies published up to August 2023. All studies comparing postoperative SSI or VTE rates in RA patients with or without bDMARD treatment were included. The protocol for this study was registered in PROSPERO (CRD42021246264) and is available on the University of York website. Results: Overall, 20 studies with 71,885 RA patients and 6 studies with 7918 RA patients were included for postoperative SSI and VTE comparisons, respectively. Patients treated with bDMARDs had significantly higher rates of postoperative SSI than those without treatment (odds ratio 1.50, 95% confidence interval 1.23–1.83, P < .0001). However, these significant differences disappeared in the analysis restricted to 9 studies involving non-tumor necrosis factor α inhibitors. The use of bDMARDs seemed to increase the rate of postoperative VTE (odds ratio 2.20, 95% confidence interval 1.30–3.72, P = .003). A subgroup analysis showed that postoperative osseous complications were significantly less frequent in RA patients with bDMARD treatment than in those without treatment. Conclusion: RA patients treated with bDMARDs had an increased risk of not only postoperative SSI but also VTE. While bDMARD usage merits appropriate attention, there might be positive aspects as well. Further data will be needed to confirm the postoperative risks of bDMARD usage in RA patients.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

General Medicine

Reference41 articles.

1. Infectious and healing complications after elective orthopaedic foot and ankle surgery during tumor necrosis factor-alpha inhibition therapy.;Bibbo;Foot Ankle Int,2004

2. Tumor necrosis factor inhibitor therapy and risk of serious postoperative orthopedic infection in rheumatoid arthritis.;Giles;Arthritis Rheum,2006

3. Risk factors for surgical site infections and other complications in elective surgery in patients with rheumatoid arthritis with special attention for anti-tumor necrosis factor: a large retrospective study.;den Broeder;J Rheumatol,2007

4. Does use of a biologic agent increase the incidence of postoperative infection in surgery for rheumatoid arthritis after total joint arthroplasty?;Kubota;Mod Rheumatol,2014

5. Risk factors for surgical site infection and delayed wound healing after orthopedic surgery in rheumatoid arthritis patients.;Kadota;Mod Rheumatol,2016

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3