The perioperative use of biologic agents in patients with rheumatoid arthritis

Ori Elkayam*, Ari Polachek, Dan Caspi

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review


Biologic drugs have gained an important place in the treatment of rheumatic diseases. These medications may, however, pose a higher risk of infections in rheumatic patients who a priori are prone to infections. The potential consequences of the immunosuppressive effects of the biologics raise concern about their safety in the perioperative setting. This article reviews the scientific literature that examines the influence of biologic drugs on post-surgical complications. According to these studies, it is apparently safe to use tumor necrosis factor-? blockers and the IL-6 receptor blocker, although a few study limitations, such as small sample size, retrospective design and differences in the comparison groups weaken the conclusions. In addition, the recommendations for some of the biologic drugs are based solely on pharmacological parameters due to the absence of trials, and larger randomized controlled studies are needed to establish the safety of their use by patients with rheumatic diseases.

Original languageEnglish
Pages (from-to)164-168
Number of pages5
JournalAutoimmunity Reviews
Issue number2
StatePublished - Dec 2012


  • Biological therapy
  • Infection
  • Perioperative period
  • Rheumatoid arthritis
  • Wound healing


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