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Low risk of adverse events, infection after anti-TNF therapy in TKR patients with RA
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Researchers from Hospital for Special Surgery found a low rate of infection and adverse events in patients with rheumatoid arthritis who undergo total knee replacement using anti-tumor necrosis factor perioperatively, according to this study.
“This raises the question whether it is necessary to stop [anti-tumor necrosis factor] anti-TNF for a long period prior to surgery,” Lisa A. Mandl, MD, and colleagues wrote in their study abstract. They added, “Given the possible risks associated with stopping anti-TNF, including worsening of disease, further study is needed to determine optimal perioperative use of anti-TNF among patients with [rheumatoid arthritis] RA undergoing [total knee replacement] TKR.
Mandl and colleagues retrospectively identified 268 patients with RA who underwent TKR. Of these patients, they noted 92 patients who self-reported anti-TNF use and progression of RA through a questionnaire and matched their results against 143 patients who did not use anti-TNF, according to the abstract.
The researchers reported seven surgical site infections, which included one deep joint infection in a bilateral TKR resulting in an explant. Stop time for anti-TNF therapy followed the dosing schedule, with therapy restarting after wound healing, according to the abstract. Adverse events in the anti-TNF group were 7.61% over 6 months as measured by the Fischer exact test, compared to 6.99% in the control group. There were also three local site infections (3.26%) in the anti-TNF group and three local site infections (2.10%) in the control. However, researchers noted the difference was not statistically significant.
Disclosure: Mandl has no relevant financial disclosures.
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