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Newer Immunosuppressants for Rheumatologic Disease: Preoperative Considerations.

Ye Rin Koh1, Kenneth C Cummings1

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Summary

Managing rheumatic diseases involves various immunosuppressants like small-molecule immune modulators and monoclonal antibodies. Careful perioperative management is crucial due to significant risks associated with these treatments.

Keywords:
Biologic therapyMedication therapy managementPerioperative periodRheumatic diseases

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Area of Science:

  • Rheumatology
  • Immunology
  • Pharmacology

Background:

  • Rheumatic diseases encompass a range of autoimmune and inflammatory conditions.
  • Treatment options have expanded with novel immunosuppressants.
  • These therapies carry substantial risks requiring careful consideration.

Purpose of the Study:

  • To review current immunosuppressant treatments for rheumatic diseases.
  • To discuss the implications of these treatments during the perioperative period.
  • To provide evidence-based recommendations for perioperative management.

Main Methods:

  • Literature review of immunosuppressant therapies.
  • Analysis of perioperative risks and benefits.
  • Synthesis of clinical guidelines and expert opinion.

Main Results:

  • Small-molecule immune modulators, fusion proteins, and monoclonal antibodies offer broad treatment options.
  • Significant risks are associated with immunosuppressive agents.
  • Individualized patient management is essential.

Conclusions:

  • A balanced approach to risk and benefit is paramount in perioperative care.
  • Recommendations for managing immunosuppressants around surgery are provided.
  • Optimizing patient outcomes requires careful perioperative planning.