The recommendation to withhold biologics before surgery and plan the procedure at the end of the dosing cycle was based on various data that suggested “the infection risk for biologics was associated with high-dose therapy, higher than standard, and wasn’t as clearly related to patients receiving low-dose therapy,” said Dr. Goodman. “We were also concerned that the serum half-life probably didn’t correspond to the duration to the immunosuppressant effect, so we felt the dosing cycle would give us the more rational approach to the withholding period.”
Patient input was a notable strength of this project, Dr. Goodman said.
“We had very clear guidance in terms of the values and preferences of the patient panel. They were very helpful in directing this effort. They found that infection was much more important than flare. They were in favor of postponing medication when the risk of infection would be increased,” she said.
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If you were unable to attend the session, Perioperative Management of Anti-Rheumatic Medications in Patients with Rheumatic Diseases Undergoing Elective Total Hip or Knee Arthroplasty, catch it now on SessionSelect.
Susan Bernstein is a freelance medical journalist based in Atlanta.
