TY - JOUR
T1 - Does Abatacept Increase Postoperative Adverse Events in Rheumatoid Arthritis Compared with Conventional Synthetic Disease-modifying Drugs?
AU - AND the JOSRA Consortium
AU - Ito, Hiromu
AU - Tsuji, Shigeyoshi
AU - Nakayama, Masanori
AU - Mochida, Yuichi
AU - Nishida, Keiichiro
AU - Ishikawa, Hajime
AU - Kojima, Toshihisa
AU - Matsumoto, Takumi
AU - Kubota, Ayako
AU - Mochizuki, Takeshi
AU - Sakuraba, Koji
AU - Matsushita, Isao
AU - Nakajima, Arata
AU - Hara, Ryota
AU - Haraguchi, Akihisa
AU - Matsubara, Tsukasa
AU - Kanbe, Katsuaki
AU - Nakagawa, Natsuko
AU - Hamaguchi, Masahide
AU - Momohara, Shigeki
N1 - Funding Information:
This work was supported by a research grant from Bristol-Myers Squibb and ONO Pharmaceutical Co. Ltd. (No. IM101-552). H. Ito has received a research grant and/or speaking fee from Bristol-Myers Squibb, Astellas, Asahi-Kasei, and Eli Lilly. S. Tsuji has received speaking fees from Eli Lilly. K. Nishida has received a scholarship donation from Chugai, and speaking fees or other remuneration from Pfizer and from ONO Pharmaceutical Co. T. Kojima has received a research grant from Chugai, Eli Lilly, and Astellas, scholarship donation from Eisai, Daiichi-Sankyo, and Novartis, and speaking fees from Chugai, Diichi-Sankyo, Pfizer, and Astellas. T. Mochizuki has received a speaking fee from Bristol-Myers Squibb, Janssen, and Mochida. I. Matsushita has received speaking fees from Bristol-Myers, Mitsubishi-Tanabe, AbbVie, Eisai, Astellas, and ONO Pharmaceutical Co. T. Matsubara has received speaker honoraria from Pfizer, Nichi-Iko, Astellas, Meiji Seika Ltd., Bristol-Myers Squibb, AbbVie, Janssen, Chugai, Eisai, and Ayumi. K. Kanbe has received speaking fees from Bristol-Myers Squibb and Mitsubishi-Tanabe.
Publisher Copyright:
© 2020 Journal of Rheumatology. All rights reserved.
PY - 2020/4/1
Y1 - 2020/4/1
N2 - Objective. To investigate whether abatacept (ABA) causes more adverse events (AE) than conventional synthetic disease-modifying antirheumatic drugs (csDMARD) after orthopedic surgery in patients with rheumatoid arthritis (RA). Methods. A retrospective multicenter nested case-control study was performed in 18 institutions. Patients receiving ABA (ABA group) were matched individually with patients receiving csDMARD and/or steroids (control group). Postoperative AE included surgical site infection, delayed wound healing, deep vein thrombosis or pulmonary embolism, flare, and death. The incidence rates of the AE in both groups were compared with the Mantel-Haenszel test. Risk factors for AE were analyzed by logistic regression model. Results. A total of 3358 cases were collected. After inclusion and exclusion, 2651 patients were selected for matching, and 194 patients in 97 pairs were chosen for subsequent comparative analyses between the ABA and control groups. No between-group differences were detected in the incidence rates of each AE or in the incidence rates of total AE (control vs ABA: 15.5% vs 20.7% in total, 5.2% vs 3.1% in death).Conclusion. Compared with csDMARD and/or steroids without ABA, adding ABA to the treatment does not appear to increase the incidence rates of postoperative AE in patients with RA undergoing orthopedic surgery. Large cohort studies should be performed to add evidence for the perioperative safety profile of ABA. (First Release November 1 2019; J Rheumatol 2020;47:502-9; doi:10.3899/jrheum.181100).
AB - Objective. To investigate whether abatacept (ABA) causes more adverse events (AE) than conventional synthetic disease-modifying antirheumatic drugs (csDMARD) after orthopedic surgery in patients with rheumatoid arthritis (RA). Methods. A retrospective multicenter nested case-control study was performed in 18 institutions. Patients receiving ABA (ABA group) were matched individually with patients receiving csDMARD and/or steroids (control group). Postoperative AE included surgical site infection, delayed wound healing, deep vein thrombosis or pulmonary embolism, flare, and death. The incidence rates of the AE in both groups were compared with the Mantel-Haenszel test. Risk factors for AE were analyzed by logistic regression model. Results. A total of 3358 cases were collected. After inclusion and exclusion, 2651 patients were selected for matching, and 194 patients in 97 pairs were chosen for subsequent comparative analyses between the ABA and control groups. No between-group differences were detected in the incidence rates of each AE or in the incidence rates of total AE (control vs ABA: 15.5% vs 20.7% in total, 5.2% vs 3.1% in death).Conclusion. Compared with csDMARD and/or steroids without ABA, adding ABA to the treatment does not appear to increase the incidence rates of postoperative AE in patients with RA undergoing orthopedic surgery. Large cohort studies should be performed to add evidence for the perioperative safety profile of ABA. (First Release November 1 2019; J Rheumatol 2020;47:502-9; doi:10.3899/jrheum.181100).
KW - Abatacept
KW - Death
KW - Infections
KW - Orthopedic surgery
KW - Perioperative complications
KW - Rheumatoid arthritis
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U2 - 10.3899/jrheum.181100
DO - 10.3899/jrheum.181100
M3 - Article
C2 - 31203226
AN - SCOPUS:85082979274
VL - 47
SP - 502
EP - 509
JO - Journal of Rheumatology
JF - Journal of Rheumatology
SN - 0315-162X
IS - 4
ER -