Stopping Biologics for Rheumatologic Disease Before Surgery Confers No Benefit

Perioperative management of patients who receive biologic disease-modifying antirheumatic drugs (bDMARDs) requires balancing risk for delayed wound healing and infection with worsened control of underlying disease. Current professional society guidelines recommend perioperative interruption of most bDMARDs; however, the quality of the supporting evidence is low. To address this uncertainty in perioperative management of patients with rheumatologic disease, researchers performed a meta-analysis of data from 11 cohort studies with >7000 patients on bDMARDs, most of whom underwent orthopedic surgeries. The most common indication for bDMARDs was rheumatoid arthritis, and tumor necrosis factor (TNF) inhibitors were the drugs used most commonly. …