Risk of postoperative complications in rheumatoid arthritis relevant to treatment with biologic agents: A report from the Committee on Arthritis of the Japanese Orthopaedic Association

Masahiko Suzuki, Keiichiro Nishida, Satoshi Soen, Hiromi Oda, Hiroshi Inoue, Atsushi Kaneko, Kenji Takagishi, Takaaki Tanaka, Tsukasa Matsubara, Naoto Mitsugi, Yuichi Mochida, Shigeki Momohara, Toshihito Mori, Toru Suguro

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Abstract

Purpose: Since biologic agents were introduced to treat rheumatoid arthritis (RA) in 2003, the number of orthopedic surgical procedures under treatment with biologic agents has been increasing in Japan. However, whether biologic agents cause an increase in the prevalence of postoperative complications is as yet unknown. The Committee on Arthritis of the Japanese Orthopedic Association investigated the prevalence of postoperative complications in patients with RA in teaching hospitals in Japan. Methods: Between January 2004 and November 2008, surveillance forms about medications and surgical procedures in patients with RA were sent to 2,019 teaching hospitals. Data were analyzed by the Rheumatoid Arthritis Committee. Results: Biologic agents were administered to RA patients in 632 of 1,245 hospitals (50.8%); 430 of the 1,245 hospitals (34.5%) used surgical intervention under treatment with biologic agents. The number of surgical procedures under treatment with biologic agents was 3,468, and the prevalence of infection was 1.3% (46 cases). The prevalence of infection was 1.0% (567 procedures) in 56,339 procedures under treatment with nonbiologic disease-modifying anti-rheumatic drugs. There were no significant differences between biological and nonbiological treatment groups with respect to the prevalence of infection. In the joint arthroplasty group, the number of procedures under biological and nonbiological treatment was 1,626 and 29,903, and the prevalence of infection was 2.1% (34 procedures) and 1.0% (298 procedures), respectively. There was a significant difference between groups. The odds ratio was 2.12 (95% confidence interval 1.48-3.03, P <0.0001). Conclusion: The chance of having biological treatment with joint arthroplasty was more than twofold greater in patients with surgical-site infections compared with those treated with nonbiologic agents. Caution is required for surgical procedure, perioperative course, and obtaining consent for joint arthroplasty for patients with RA undergoing surgery under biological agents.

Original languageEnglish
Pages (from-to)778-784
Number of pages7
JournalJournal of Orthopaedic Science
Volume16
Issue number6
DOIs
Publication statusPublished - Nov 2011

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Biological Factors
Arthritis
Rheumatoid Arthritis
Arthroplasty
Therapeutics
Joints
Infection
Teaching Hospitals
Japan
Orthopedic Procedures
Surgical Wound Infection
Antirheumatic Agents
Orthopedics
Odds Ratio
Confidence Intervals

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

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Risk of postoperative complications in rheumatoid arthritis relevant to treatment with biologic agents : A report from the Committee on Arthritis of the Japanese Orthopaedic Association. / Suzuki, Masahiko; Nishida, Keiichiro; Soen, Satoshi; Oda, Hiromi; Inoue, Hiroshi; Kaneko, Atsushi; Takagishi, Kenji; Tanaka, Takaaki; Matsubara, Tsukasa; Mitsugi, Naoto; Mochida, Yuichi; Momohara, Shigeki; Mori, Toshihito; Suguro, Toru.

In: Journal of Orthopaedic Science, Vol. 16, No. 6, 11.2011, p. 778-784.

Research output: Contribution to journalArticle

Suzuki, M, Nishida, K, Soen, S, Oda, H, Inoue, H, Kaneko, A, Takagishi, K, Tanaka, T, Matsubara, T, Mitsugi, N, Mochida, Y, Momohara, S, Mori, T & Suguro, T 2011, 'Risk of postoperative complications in rheumatoid arthritis relevant to treatment with biologic agents: A report from the Committee on Arthritis of the Japanese Orthopaedic Association', Journal of Orthopaedic Science, vol. 16, no. 6, pp. 778-784. https://doi.org/10.1007/s00776-011-0142-3
Suzuki, Masahiko ; Nishida, Keiichiro ; Soen, Satoshi ; Oda, Hiromi ; Inoue, Hiroshi ; Kaneko, Atsushi ; Takagishi, Kenji ; Tanaka, Takaaki ; Matsubara, Tsukasa ; Mitsugi, Naoto ; Mochida, Yuichi ; Momohara, Shigeki ; Mori, Toshihito ; Suguro, Toru. / Risk of postoperative complications in rheumatoid arthritis relevant to treatment with biologic agents : A report from the Committee on Arthritis of the Japanese Orthopaedic Association. In: Journal of Orthopaedic Science. 2011 ; Vol. 16, No. 6. pp. 778-784.
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abstract = "Purpose: Since biologic agents were introduced to treat rheumatoid arthritis (RA) in 2003, the number of orthopedic surgical procedures under treatment with biologic agents has been increasing in Japan. However, whether biologic agents cause an increase in the prevalence of postoperative complications is as yet unknown. The Committee on Arthritis of the Japanese Orthopedic Association investigated the prevalence of postoperative complications in patients with RA in teaching hospitals in Japan. Methods: Between January 2004 and November 2008, surveillance forms about medications and surgical procedures in patients with RA were sent to 2,019 teaching hospitals. Data were analyzed by the Rheumatoid Arthritis Committee. Results: Biologic agents were administered to RA patients in 632 of 1,245 hospitals (50.8{\%}); 430 of the 1,245 hospitals (34.5{\%}) used surgical intervention under treatment with biologic agents. The number of surgical procedures under treatment with biologic agents was 3,468, and the prevalence of infection was 1.3{\%} (46 cases). The prevalence of infection was 1.0{\%} (567 procedures) in 56,339 procedures under treatment with nonbiologic disease-modifying anti-rheumatic drugs. There were no significant differences between biological and nonbiological treatment groups with respect to the prevalence of infection. In the joint arthroplasty group, the number of procedures under biological and nonbiological treatment was 1,626 and 29,903, and the prevalence of infection was 2.1{\%} (34 procedures) and 1.0{\%} (298 procedures), respectively. There was a significant difference between groups. The odds ratio was 2.12 (95{\%} confidence interval 1.48-3.03, P <0.0001). Conclusion: The chance of having biological treatment with joint arthroplasty was more than twofold greater in patients with surgical-site infections compared with those treated with nonbiologic agents. Caution is required for surgical procedure, perioperative course, and obtaining consent for joint arthroplasty for patients with RA undergoing surgery under biological agents.",
author = "Masahiko Suzuki and Keiichiro Nishida and Satoshi Soen and Hiromi Oda and Hiroshi Inoue and Atsushi Kaneko and Kenji Takagishi and Takaaki Tanaka and Tsukasa Matsubara and Naoto Mitsugi and Yuichi Mochida and Shigeki Momohara and Toshihito Mori and Toru Suguro",
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T1 - Risk of postoperative complications in rheumatoid arthritis relevant to treatment with biologic agents

T2 - A report from the Committee on Arthritis of the Japanese Orthopaedic Association

AU - Suzuki, Masahiko

AU - Nishida, Keiichiro

AU - Soen, Satoshi

AU - Oda, Hiromi

AU - Inoue, Hiroshi

AU - Kaneko, Atsushi

AU - Takagishi, Kenji

AU - Tanaka, Takaaki

AU - Matsubara, Tsukasa

AU - Mitsugi, Naoto

AU - Mochida, Yuichi

AU - Momohara, Shigeki

AU - Mori, Toshihito

AU - Suguro, Toru

PY - 2011/11

Y1 - 2011/11

N2 - Purpose: Since biologic agents were introduced to treat rheumatoid arthritis (RA) in 2003, the number of orthopedic surgical procedures under treatment with biologic agents has been increasing in Japan. However, whether biologic agents cause an increase in the prevalence of postoperative complications is as yet unknown. The Committee on Arthritis of the Japanese Orthopedic Association investigated the prevalence of postoperative complications in patients with RA in teaching hospitals in Japan. Methods: Between January 2004 and November 2008, surveillance forms about medications and surgical procedures in patients with RA were sent to 2,019 teaching hospitals. Data were analyzed by the Rheumatoid Arthritis Committee. Results: Biologic agents were administered to RA patients in 632 of 1,245 hospitals (50.8%); 430 of the 1,245 hospitals (34.5%) used surgical intervention under treatment with biologic agents. The number of surgical procedures under treatment with biologic agents was 3,468, and the prevalence of infection was 1.3% (46 cases). The prevalence of infection was 1.0% (567 procedures) in 56,339 procedures under treatment with nonbiologic disease-modifying anti-rheumatic drugs. There were no significant differences between biological and nonbiological treatment groups with respect to the prevalence of infection. In the joint arthroplasty group, the number of procedures under biological and nonbiological treatment was 1,626 and 29,903, and the prevalence of infection was 2.1% (34 procedures) and 1.0% (298 procedures), respectively. There was a significant difference between groups. The odds ratio was 2.12 (95% confidence interval 1.48-3.03, P <0.0001). Conclusion: The chance of having biological treatment with joint arthroplasty was more than twofold greater in patients with surgical-site infections compared with those treated with nonbiologic agents. Caution is required for surgical procedure, perioperative course, and obtaining consent for joint arthroplasty for patients with RA undergoing surgery under biological agents.

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