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Perioperative Management of Immunosuppressive Medications for Rheumatoid Arthritis

Andrew M Hresko1, Christopher J Got1, Joseph A Gil1

  • 1Department of Orthopaedic Surgery, Brown University, Providence, RI.

The Journal of Hand Surgery
|February 21, 2022
PubMed

Operations in patients with rheumatoid arthritis are complicated by the fact that most drugs used in medical management have immunosuppressive mechanisms of action, including corticosteroids and conventional synthetic and biologic disease-modifying antirheumatic drugs. In deciding to continue or discontinue these medications perioperatively, surgeons must weigh the relative risk of infection from immunosuppression against the risk of rheumatoid arthritis symptom flares from reduced medical disease control. The objective of this article is to review the existing evidence regarding perioperative management of immunosuppressive rheumatoid arthritis medications, with a specific focus on relevance to hand and upper-extremity procedures.

Keywords:
Biologic synthetic disease-modifying antirheumatic drugsconventional synthetic disease-modifying antirheumatic drugscorticosteroidsdisease-modifying antirheumatic drugsrheumatoid arthritis

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