When Should Biologics Be Stopped Prior to Joint Replacement Surgery?

Patients who take biologic therapies for autoimmune diseases are at heightened risk for infections. Various guidelines suggest that such patients stop taking biologics before undergoing elective surgery, but withholding these drugs for too long might allow underlying diseases (e.g., rheumatoid arthritis) to flare, resulting in poorer surgical outcomes. In this retrospective study, researchers used Medicare claims data to examine postsurgical infection rates in patients with who received infliximab within 6 months before undergoing knee or hip replacement surgery.

Serious infection within 30 days occurred in 6% of 4288 surgeries; the rate of prosthetic joint infection within 1 year was 2.9 per 100 person-years. For both outcomes, risk was no …