Haerle, Peter and Straub, Rainer H. and Fleck, Martin (2010) Perioperative management of immunosuppression in rheumatic diseases-what to do? RHEUMATOLOGY INTERNATIONAL, 30 (8). pp. 999-1004. ISSN 0172-8172, 1437-160X
Full text not available from this repository. (Request a copy)Abstract
To stop or not to stop immunosuppressive therapy in the perioperative setting puts the clinician to a challenge. The risk of potential wound infection with possible septic or even lethal consequences needs to be weighted against exacerbation of the rheumatic disease. However, exacerbation of autoimmune inflammatory activity needs to be treated with increasing immunosuppressive medication, thus leading to enhanced risk of local and systemic infection as well. Unfortunately, up to now there is no data from randomized, double-blind controlled clinical trials available on how to steer immunosuppressive therapy in the perioperative setting, making evidence-based recommendations difficult. Neither is there good evidence, if the risk of infectious complications under immunosuppressive therapy differs according to the type and localization of surgery performed. Finally, immunosuppressive co-medication, like glucocorticoid dosage, is not adequately addressed in the available studies, making interpretation of these studies even more problematic. Therefore, a decision has to be made on an individual basis. We discuss the available data on DMARD and biologics therapy in the perioperative setting and describe our own perioperative management with different DMARDs and biologics.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | ELECTIVE ORTHOPEDIC-SURGERY; ANTITUMOR NECROSIS FACTOR; TOTAL HIP-ARTHROPLASTY; INFECTIOUS COMPLICATIONS; COMBINATION THERAPY; ARTHRITIS PATIENTS; POSTOPERATIVE COMPLICATIONS; HEALING COMPLICATIONS; CYTOKINE PRODUCTION; METHOTREXATE; Elective surgery; Rheumatoid arthritis; DMARD; Infections; Wound healing |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin I |
| Depositing User: | Petra Gürster |
| Date Deposited: | 15 Apr 2020 10:45 |
| Last Modified: | 15 Apr 2020 10:45 |
| URI: | https://pred.uni-regensburg.de/id/eprint/24680 |
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