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AB0311 Postoperative complications in rheumatoid arthritis patients receiving rituximab and conventional disease-modifying antirheumatic drugs (dmards)
  1. E. Pogozheva1,
  2. V. Amirdzhanova1,
  3. S. Makarov2
  1. 1Department Of Medical-Social Investigations
  2. 2department of orthopedic surgery, Federal State Budgetary Institution “Research Institute of Rheumatology” of RAMS, Moscow, Russian Federation

Abstract

Background Biologic DMARDs represent a new challenge in the perioperative management of patients who require surgery. Very little is known about the possible effects of biologics on the risk of postoperative complications. At present, no studies have evaluated the perioperative use of rituximab (RTX).

Objectives To identify complications after total joint arthroplasty in rheumatoid arthritis (RA) patients treated with RTX and conventional DMARDs.

Methods In a retrospective 1:1 pair-matched case–control study 40 patients with RA after total hip arthroplasty (THA) and total knee arthroplasty (TKA), matched in type of surgery and gender, were evaluated for surgical site infection (SSI) and deep venous thrombosis (DVT) in the postoperative period. Patients with RA were split into a RTX group (n = 20) and a DMARDs group (n = 20) treated only with conventional DMARDs (14 pts – methotrexate and 6 - leflunomide). Conventional DMARDs were continued perioperatively. In RTX group 8 pts discontinued treatment < 6 months before surgery, 12 pts was stopped and restarted RTX in accordance with Russian guidelines. Baseline characteristics were compared using the Mann-Whitney U-test or Fisher’s exact test.

Results Table 1 shows the baseline characteristics of the pts. For the period from 2 till 24 months after surgery 2 pts had DVT, one pt in RTX group and one in DMARDs group. We identified 2 cases with postoperative complications of superficial infections requiring the use of antibiotics, all in DMARDs group. Deep infection was not found.

Conclusions In patients with RA, RTX therapy in perioperative period does not lead to an increase in complications after joint surgery. Prospective studies are thus needed to determine the safety of RTX treatment in the perioperative period

Disclosure of Interest None Declared

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