PT  - JOURNAL ARTICLE
AU  - Hiromu Ito
AU  - Shigeyoshi Tsuji
AU  - Masanori Nakayama
AU  - Yuichi Mochida
AU  - Keiichiro Nishida
AU  - Hajime Ishikawa
AU  - Toshihisa Kojima
AU  - Takumi Matsumoto
AU  - Ayako Kubota
AU  - Takeshi Mochizuki
AU  - Koji Sakuraba
AU  - Isao Matsushita
AU  - Arata Nakajima
AU  - Ryota Hara
AU  - Akihisa Haraguchi
AU  - Tsukasa Matsubara
AU  - Katsuaki Kanbe
AU  - Natsuko Nakagawa
AU  - Masahide Hamaguchi
AU  - Shigeki Momohara
AU  - the JOSRA Consortium
TI  - Does Abatacept Increase Postoperative Adverse Events in Rheumatoid Arthritis Compared with Conventional Synthetic Disease-modifying Drugs?
AID  - 10.3899/jrheum.181100
DP  - 2020 Apr 01
TA  - The Journal of Rheumatology
PG  - 502--509
VI  - 47
IP  - 4
4099  - http://www.jrheum.org/content/47/4/502.short
4100  - http://www.jrheum.org/content/47/4/502.full
SO  - J Rheumatol2020 Apr 01; 47
AB  - Objective. To investigate whether abatacept (ABA) causes more adverse events (AE) than conventional synthetic disease-modifying antirheumatic drugs (csDMARD) after orthopedic surgery in patients with rheumatoid arthritis (RA).Methods. A retrospective multicenter nested case–control study was performed in 18 institutions. Patients receiving ABA (ABA group) were matched individually with patients receiving csDMARD and/or steroids (control group). Postoperative AE included surgical site infection, delayed wound healing, deep vein thrombosis or pulmonary embolism, flare, and death. The incidence rates of the AE in both groups were compared with the Mantel-Haenszel test. Risk factors for AE were analyzed by logistic regression model.Results. A total of 3358 cases were collected. After inclusion and exclusion, 2651 patients were selected for matching, and 194 patients in 97 pairs were chosen for subsequent comparative analyses between the ABA and control groups. No between-group differences were detected in the incidence rates of each AE or in the incidence rates of total AE (control vs ABA: 15.5% vs 20.7% in total, 5.2% vs 3.1% in death).Conclusion. Compared with csDMARD and/or steroids without ABA, adding ABA to the treatment does not appear to increase the incidence rates of postoperative AE in patients with RA undergoing orthopedic surgery. Large cohort studies should be performed to add evidence for the perioperative safety profile of ABA.