15:53 PM

Guideline: Timing Is Everything for RA and Lupus Patients Needing Joint Replacement

MedPage Today reports conventional disease-modifying antirheumatic drugs (DMARDs) may usually be continued in patients with inflammatory arthritis or systemic lupus erythematosus (SLE) undergoing total knee or hip replacement, but the same is not necessarily true for more targeted agents, according to an updated guideline published by the American College of Rheumatology and the American Association of Hip and Knee Surgeons.

Susan M. Goodman, MD, rheumatologist at HSS, is lead author of the guideline.

The guideline states biologic drugs and so-called janus kinase (JAK) inhibitors should generally be stopped before arthritis patients have such procedures, and so should biologics such as belimumab and immunosuppressants in patients with non-severe systemic lupus erythematosus (SLE).

Dr. Goodman and colleagues noted that rheumatic disease patients are at substantially higher risk of periprosthetic infection following joint replacement relative to people without such conditions -- by 50% in the case of rheumatoid arthritis. The immunomodulatory drugs that most of these patients take surely contribute to this increased risk.

Dr. Goodman and colleagues emphasized that these are not intended as hard-and-fast rules and clinicians should engage in shared decision-making with patients to take account of their particular preferences and circumstances.

Read the full article at MedPagetoday.com.