Postoperative complications in patients with rheumatoid arthritis using a biological agent - A systematic review and meta-analysis

Hiromu Ito, Masayo Kojima, Keiichiro Nishida, Isao Matsushita, Toshihisa Kojima, Takeo Nakayama, Hirahito Endo, Shintaro Hirata, Yuko Kaneko, Yutaka Kawahito, Mitsumasa Kishimoto, Yohei Seto, Naoyuki Kamatani, Kiichiro Tsutani, Ataru Igarashi, Mieko Hasegawa, Nobuyuki Miyasaka, Hisashi Yamanaka

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)672-678
Number of pages7
JournalModern Rheumatology
Volume25
Issue number5
DOIs
Publication statusPublished - 2015 Sep 3

Fingerprint

Surgical Wound Infection
Biological Factors
Antirheumatic Agents
Wound Healing
Meta-Analysis
Rheumatoid Arthritis
PubMed
Orthopedics
Replacement Arthroplasties
Libraries
Tumor Necrosis Factor-alpha

Keywords

  • Biological agent
  • Delayed wound healing
  • Perioperative complication
  • Rheumatoid arthritis
  • Surgical site infection
  • Systematic review

ASJC Scopus subject areas

  • Rheumatology

Cite this

Postoperative complications in patients with rheumatoid arthritis using a biological agent - A systematic review and meta-analysis. / Ito, Hiromu; Kojima, Masayo; Nishida, Keiichiro; Matsushita, Isao; Kojima, Toshihisa; Nakayama, Takeo; Endo, Hirahito; Hirata, Shintaro; Kaneko, Yuko; Kawahito, Yutaka; Kishimoto, Mitsumasa; Seto, Yohei; Kamatani, Naoyuki; Tsutani, Kiichiro; Igarashi, Ataru; Hasegawa, Mieko; Miyasaka, Nobuyuki; Yamanaka, Hisashi.

In: Modern Rheumatology, Vol. 25, No. 5, 03.09.2015, p. 672-678.

Research output: Contribution to journalArticle

Ito, H, Kojima, M, Nishida, K, Matsushita, I, Kojima, T, Nakayama, T, Endo, H, Hirata, S, Kaneko, Y, Kawahito, Y, Kishimoto, M, Seto, Y, Kamatani, N, Tsutani, K, Igarashi, A, Hasegawa, M, Miyasaka, N & Yamanaka, H 2015, 'Postoperative complications in patients with rheumatoid arthritis using a biological agent - A systematic review and meta-analysis', Modern Rheumatology, vol. 25, no. 5, pp. 672-678. https://doi.org/10.3109/14397595.2015.1014302
Ito, Hiromu ; Kojima, Masayo ; Nishida, Keiichiro ; Matsushita, Isao ; Kojima, Toshihisa ; Nakayama, Takeo ; Endo, Hirahito ; Hirata, Shintaro ; Kaneko, Yuko ; Kawahito, Yutaka ; Kishimoto, Mitsumasa ; Seto, Yohei ; Kamatani, Naoyuki ; Tsutani, Kiichiro ; Igarashi, Ataru ; Hasegawa, Mieko ; Miyasaka, Nobuyuki ; Yamanaka, Hisashi. / Postoperative complications in patients with rheumatoid arthritis using a biological agent - A systematic review and meta-analysis. In: Modern Rheumatology. 2015 ; Vol. 25, No. 5. pp. 672-678.
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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

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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.

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