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Surgical Infection Rate Higher with RA Drugs Marianne Wait writing in Arthritis Today reported
that people with inflammatory forms of arthritis, such as rheumatoid arthritis, who take more
than one traditional disease modifying antirheumatic drug (DMARD), or a type of biologic drug known
as a TNF inhibitor, have an increased risk of infection following orthopaedic surgery,
according to a new study published in Arthritis Care & Research in December.
It is not a new theory that drugs taken for inflammatory arthritis conditions, which in
many cases work by suppressing the immune system, might increase post-surgical infections.
Over the years, a host of studies has looked at which drugs might elevate the risk and
by how much. The results have not been clear. But this study "is one of the best out there
regarding this topic," says Tim Bongartz, MD, associate professor of rheumatology at
Mayo Clinic in Rochester, Minn. Dr. Bongartz was not involved in the study.
Based on their results, senior study author Inès A. Kramers-de Quervain, MD, of the department
of rheumatology at the Schulthess Clinic in Zurich, Switzerland, suggests "it may be advisable
to consider stopping TNF inhibitors more than one administration interval before surgery,
since the risk of postoperative infection appears to be higher if the operation occurs
within this period." An administration interval is the length of time between one injection
and the next.