TY - JOUR
T1 - Postoperative complications in patients with rheumatoid arthritis using a biological agent - A systematic review and meta-analysis
AU - Ito, Hiromu
AU - Kojima, Masayo
AU - Nishida, Keiichiro
AU - Matsushita, Isao
AU - Kojima, Toshihisa
AU - Nakayama, Takeo
AU - Endo, Hirahito
AU - Hirata, Shintaro
AU - Kaneko, Yuko
AU - Kawahito, Yutaka
AU - Kishimoto, Mitsumasa
AU - Seto, Yohei
AU - Kamatani, Naoyuki
AU - Tsutani, Kiichiro
AU - Igarashi, Ataru
AU - Hasegawa, Mieko
AU - Miyasaka, Nobuyuki
AU - Yamanaka, Hisashi
PY - 2015/9/3
Y1 - 2015/9/3
N2 - Objectives. To evaluate, through a systematic review of the literature, the association between the use of biological disease-modifying antirheumatic drugs (bDMARDs) and surgical site infection (SSI) or wound healing delay after orthopedic surgery in patients with rheumatoid arthritis (RA). Methods. A systematic review of articles indexed in the Cochrane Library, PubMed, and Web of Science from 1992 to 2012 was performed. The search aimed to identify studies describing SSI or wound healing delay in patients with RA treated with or without bDMARDs. Articles fulfilling the predefined inclusion criteria were reviewed systematically and their quality was appraised. Results. There was no Cochrane review on this subject. We found 75 articles through specific searches of PubMed and Web of Science, and hand searching. After inclusion and exclusion by full-text review, 10 articles were found for SSI, and 5 articles for delayed wound healing. The use of bDMARDs appeared to increase the rate of SSI slightly, especially in large joint-replacement surgery. Delayed wound healing was not increased by the use of bDMARDs. However, the definitions of SSI and delayed wound healing varied between the reviewed articles. Most of the articles focused on tumor necrosis factor-α inhibitors. Conclusion. bDMARDs slightly increase the relative risk of SSI but not that of delayed wound healing after orthopedic surgery and should be used with appropriate caution.
AB - Objectives. To evaluate, through a systematic review of the literature, the association between the use of biological disease-modifying antirheumatic drugs (bDMARDs) and surgical site infection (SSI) or wound healing delay after orthopedic surgery in patients with rheumatoid arthritis (RA). Methods. A systematic review of articles indexed in the Cochrane Library, PubMed, and Web of Science from 1992 to 2012 was performed. The search aimed to identify studies describing SSI or wound healing delay in patients with RA treated with or without bDMARDs. Articles fulfilling the predefined inclusion criteria were reviewed systematically and their quality was appraised. Results. There was no Cochrane review on this subject. We found 75 articles through specific searches of PubMed and Web of Science, and hand searching. After inclusion and exclusion by full-text review, 10 articles were found for SSI, and 5 articles for delayed wound healing. The use of bDMARDs appeared to increase the rate of SSI slightly, especially in large joint-replacement surgery. Delayed wound healing was not increased by the use of bDMARDs. However, the definitions of SSI and delayed wound healing varied between the reviewed articles. Most of the articles focused on tumor necrosis factor-α inhibitors. Conclusion. bDMARDs slightly increase the relative risk of SSI but not that of delayed wound healing after orthopedic surgery and should be used with appropriate caution.
KW - Biological agent
KW - Delayed wound healing
KW - Perioperative complication
KW - Rheumatoid arthritis
KW - Surgical site infection
KW - Systematic review
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U2 - 10.3109/14397595.2015.1014302
DO - 10.3109/14397595.2015.1014302
M3 - Article
C2 - 25671400
AN - SCOPUS:84940551181
VL - 25
SP - 672
EP - 678
JO - Modern Rheumatology
JF - Modern Rheumatology
SN - 1439-7595
IS - 5
ER -