Does perioperative discontinuation of anti-rheumatic drugs increase postoperative complications in orthopedic surgery for rheumatoid arthritis?
Authors' conclusion
In orthopedic surgery for patients with RA, maintaining the standard or the half of administration interval of bDMARD appears safe in the preoperative period. However, the drug discontinuation may increase the risk of postoperative flare-ups, particularly with IL-6 inhibitors.
Study context
- Population
- Patients with rheumatoid arthritis (RA) receiving bDMARDs or tsDMARDs who underwent orthopedic surgery1,953 analysed
- Participants
- 2,060 patients
- Exposure
- Perioperative discontinuation vs continuation of bDMARDs or tsDMARDs
- Outcome
- Postoperative complications: delayed wound healing, SSI, disease flare-ups and mortality
Methodological detailsmulticentre, multivariate analysis
- Multicentre
- Multivariate analysis
Main finding
As reported in the abstract
Postoperative complications
- No significant differences between the groups in delayed wound healing, surgical site infection (SSI) or mortality
- Incidence of disease flare-ups substantially higher in the drug discontinuation group and in the IL-6 inhibitor group
Observational data: associations, not effects.
Further findings
Risk factors for delayed wound healing (multivariate analysis)
- TNFα and IL-6 inhibitor use associated with higher risk of delayed wound healing relative to T-cell function modifiers
Original publication
Does perioperative discontinuation of anti-rheumatic drugs increase postoperative complications in orthopedic surgery for rheumatoid arthritis? Arthritis Res Ther. Published 21 November 2025. doi:10.
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