RT Journal Article
SR Electronic
T1 Does Abatacept Increase Postoperative Adverse Events in Rheumatoid Arthritis Compared with Conventional Synthetic Disease-modifying Drugs?
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 502
OP 509
DO 10.3899/jrheum.181100
VO 47
IS 4
A1 Hiromu Ito
A1 Shigeyoshi Tsuji
A1 Masanori Nakayama
A1 Yuichi Mochida
A1 Keiichiro Nishida
A1 Hajime Ishikawa
A1 Toshihisa Kojima
A1 Takumi Matsumoto
A1 Ayako Kubota
A1 Takeshi Mochizuki
A1 Koji Sakuraba
A1 Isao Matsushita
A1 Arata Nakajima
A1 Ryota Hara
A1 Akihisa Haraguchi
A1 Tsukasa Matsubara
A1 Katsuaki Kanbe
A1 Natsuko Nakagawa
A1 Masahide Hamaguchi
A1 Shigeki Momohara
A1 the JOSRA Consortium
YR 2020
UL http://www.jrheum.org/content/47/4/502.abstract
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.