Perioperative Timing of Infliximab and the Risk of Serious Infection After Elective Hip and Knee Arthroplasty

Objective The optimal timing of tumor necrosis factor antagonists before elective surgery is unknown. This study evaluated the association between infliximab timing and serious infection after elective hip or knee arthroplasty. Methods A retrospective cohort study evaluated US Medicare patients with...

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Bibliographic Details
Published in:Arthritis care & research (2010) 2017-12, Vol.69 (12), p.1845-1854
Main Authors: George, Michael D., Baker, Joshua F., Hsu, Jesse Yenchih, Wu, Qufei, Xie, Fenglong, Chen, Lang, Yun, Huifeng, Curtis, Jeffrey R.
Format: Article
Language:English
Subjects:
Aged
Ankylosing spondylitis
Antagonists
Antirheumatic Agents - administration & dosage
Antirheumatic Agents - adverse effects
Arthritis
Arthroplasty (hip)
Arthroplasty (knee)
Arthroplasty, Replacement, Hip - adverse effects
Arthroplasty, Replacement, Hip - instrumentation
Arthroplasty, Replacement, Knee - adverse effects
Arthroplasty, Replacement, Knee - instrumentation
Chi-Square Distribution
Drug Administration Schedule
Elective Surgical Procedures
Female
Geriatrics
Glucocorticoids
Glucocorticoids - administration & dosage
Glucocorticoids - adverse effects
Hip
Hip Joint - physiopathology
Hip Joint - surgery
Hip Prosthesis - adverse effects
Hospitalization
Humans
Immunocompromised Host
Immunotherapy
Infections
Inflammatory bowel diseases
Infliximab
Infliximab - administration & dosage
Infliximab - adverse effects
Intestine
Joint diseases
Joint surgery
Kaplan-Meier Estimate
Knee
Knee Joint - physiopathology
Knee Joint - surgery
Knee Prosthesis - adverse effects
Logistic Models
Male
Medicare
Monoclonal antibodies
Multivariate Analysis
Odds Ratio
Propensity Score
Proportional Hazards Models
Prosthesis-Related Infections - diagnosis
Prosthesis-Related Infections - immunology
Prosthesis-Related Infections - microbiology
Psoriasis
Psoriatic arthritis
Retrospective Studies
Rheumatoid arthritis
Risk Factors
Spondylitis
Surgery
Time Factors
TNF inhibitors
Treatment Outcome
Tumor necrosis factor-α
United States
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Summary:Objective The optimal timing of tumor necrosis factor antagonists before elective surgery is unknown. This study evaluated the association between infliximab timing and serious infection after elective hip or knee arthroplasty. Methods A retrospective cohort study evaluated US Medicare patients with rheumatoid arthritis, inflammatory bowel disease, psoriasis, psoriatic arthritis, or ankylosing spondylitis who received infliximab within 6 months of elective knee or hip arthroplasty from 2007 to 2013. Propensity‐adjusted analyses examined whether infliximab stop timing (time between the most recent infusion and surgery) was associated with hospitalized infection within 30 days or prosthetic joint infection (PJI) within 1 year. Results Hospitalized infection within 30 days occurred after 270 of 4,288 surgeries (6.3%). Infliximab stop timing 10 mg/day, was associated with an increased infection risk.
ISSN:2151-464X
2151-4658
DOI:10.1002/acr.23209