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Perioperative management of biologic agents used in treatment of rheumatoid arthritis.
MedLine Citation:
PMID:  20216205     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Patients with rheumatoid arthritis, an inflammatory arthritis that can destroy joint structures, are often on multiple disease-modifying antirheumatic medications to control disease activity. These medications have significant toxicities, most notably immunosuppression leading to increased risk of infection. Furthermore, certain disease-modifying antirheumatic medications have been reported to affect the healing process. Over the course of their lifetime, patients with rheumatoid arthritis may undergo many surgical procedures, often orthopedic interventions, including total joint arthroplasty, reconstructive surgeries, or cervical stabilization. How to manage antirheumatic medications and their toxicities in the perioperative period is a challenging question, especially with regard to the biologic therapies such as antitumor necrosis factor alpha agents. We conducted a review of the available literature pertaining to the perioperative use of biologic agents used to treat rheumatoid arthritis. Although existing data directly addressing complications during specific orthopedic procedures are sparse, information on general surgical complications in rheumatic and other patient populations may be used as a basis for conservative recommendations.
Authors:
Saulat Mushtaq; Susan M Goodman; Carla R Scanzello
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of therapeutics     Volume:  18     ISSN:  1536-3686     ISO Abbreviation:  Am J Ther     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-09-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9441347     Medline TA:  Am J Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  426-34     Citation Subset:  IM    
Affiliation:
1Section of Rheumatology, Rush University Medical Center, Chicago, IL; and 2Division of Rheumatology, Hospital for Special Surgery, New York, NY.
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