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Complication risk not related to timing between rituximab, surgery for RA patients
Postoperative complications did not appear to be related to the time between surgery and the last rituximab infusion for patients with rheumatoid arthritis, according to study results.
Jérémie Sellam, MD, PhD, of the department of rheumatology, University of Paris VI, and colleagues studied 133 patients with rheumatoid arthritis (RA; median age, 59 years) who underwent 140 procedures within 1 year of rituximab (RTX) infusion and had at least one follow-up visit. Data were reviewed for incidence of postsurgical complications, comparison of patients with and without complications, and factors associated with complications.
Jérémie Sellam
Procedures included 94 orthopedic, 23 abdominal and 23 other unrelated surgeries. Patients received two 1-g RTX infusions, with 82.8% of procedures requiring methylprednisolone administration as pre-medication during the final RTX cycle.
Median delay was 6.4 months (interquartile range, 4.3-8.7 months) between surgery and last RTX infusion; there were no differences between patients with and without complications.
Nine patients (88.8% women) experienced 12 complications (8.5%), including eight surgical site infections (5.7%) and one death related to septic shock. Postoperative complications occurred in 7.4% of orthopedic surgeries and 4.3% of abdominal procedures. Spine surgery had an association with postoperative complications (P=.048), according to univariate analysis.
“The rate of short-term postoperative complications in RA patients receiving a few cycles of RTX is 8.5%,” the researchers concluded. “The risk of complications may be more important in case of spine surgery but does not seem linked to the time between last RTX infusion and surgery.”
Disclosure: See the study for a full list of relevant disclosures.