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Tytuł pozycji:

Systemic inflammatory responses after orthopedic surgery in patients with rheumatoid arthritis treated with tofacitinib.

Tytuł:
Systemic inflammatory responses after orthopedic surgery in patients with rheumatoid arthritis treated with tofacitinib.
Autorzy:
Uchio A; Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.; Department of Orthopaedic Surgery, National Hospital Organization, Sagamihara Hospital, 18-1 Sakuradai, Minami-ku, Sagamihara City, Kanagawa, 252-0314, Japan.
Matsumoto T; Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. .
Maenohara Y; Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
Omata Y; Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
Takahashi H; Department of Rheumatology, JCHO Yugawara Hospital, 2-21-6 Chuo, Yugawara, Ashigara-shimo, Kanagawa, 259-0396, Japan.
Iwasawa M; Department of Orthopaedic Surgery, National Hospital Organization, Sagamihara Hospital, 18-1 Sakuradai, Minami-ku, Sagamihara City, Kanagawa, 252-0314, Japan.
Juji T; Department of Rheumatology, JCHO Yugawara Hospital, 2-21-6 Chuo, Yugawara, Ashigara-shimo, Kanagawa, 259-0396, Japan.
Nakamura I; Department of Rheumatology, JCHO Yugawara Hospital, 2-21-6 Chuo, Yugawara, Ashigara-shimo, Kanagawa, 259-0396, Japan.
Tanaka S; Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
Źródło:
Clinical rheumatology [Clin Rheumatol] 2021 Dec; Vol. 40 (12), pp. 5077-5083. Date of Electronic Publication: 2021 Sep 21.
Typ publikacji:
Journal Article
Język:
English
Imprint Name(s):
Publication: <2008->: Heidelberg : Springer
Original Publication: Brussels : Acta Medica Belgica, [1982-
MeSH Terms:
Antirheumatic Agents*/therapeutic use
Arthritis, Rheumatoid*/drug therapy
Arthritis, Rheumatoid*/surgery
Orthopedic Procedures*
Humans ; Infant, Newborn ; Piperidines ; Pyrimidines ; Pyrroles/therapeutic use ; Retrospective Studies ; Treatment Outcome
References:
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Smolen JS, Landewé RBM, Bijlsma JWJ, Burmester GR, Dougados M, Kerschbaumer A et al (2020) EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2019 update. Ann Rheum Dis 79:685–699. https://doi.org/10.1136/annrheumdis-2019-216655. (PMID: 10.1136/annrheumdis-2019-21665531969328)
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Contributed Indexing:
Keywords: Surgery; Systemic inflammatory response; Tofacitinib
Substance Nomenclature:
0 (Antirheumatic Agents)
0 (Piperidines)
0 (Pyrimidines)
0 (Pyrroles)
87LA6FU830 (tofacitinib)
Entry Date(s):
Date Created: 20210921 Date Completed: 20211119 Latest Revision: 20211119
Update Code:
20240105
DOI:
10.1007/s10067-021-05914-1
PMID:
34545450
Czasopismo naukowe
Objective: To investigate the acute phase response to surgical stress in patients with rheumatoid arthritis (RA) treated with tofacitinib, a Janus kinase (JAK) inhibitor.
Methods: A retrospective matched pair analysis of 34 patients treated with tofacitinib and 34 patients treated with conventional disease-modifying anti-rheumatic drugs (csDMARDs) was performed. Patients were matched for age, sex, and type of surgery; body temperature, C-reactive protein (CRP) level, and white blood cell (WBC) count, neutrophil count, and lymphocyte count were compared between the tofacitinib and csDMARDs groups within 2 weeks after orthopedic surgery. Postoperative complications within 90 days were also assessed.
Results: No surgical site infection or delayed wound healing was observed in the tofacitinib group; whereas, one case of superficial infection was noted in the csDMARDs group. A similar postoperative increase in body temperature and CRP level was observed in both the groups. Postoperatively, the tofacitinib group showed an increase in WBC and neutrophils counts and a decrease in lymphocyte count, unlike the csDMARDs group. In contrast to two patients (2.6%) in the csDMARDs group, seven patients (20.6%) in the tofacitinib group had lymphocyte counts below 500 cells/μL within 2 weeks postoperatively.
Conclusion: Tofacitinib did not suppress postoperative increase in body temperature and CRP level. Because of the postoperative decrease in lymphocyte count in patients treated with tofacitinib, the timing for resuming tofacitinib treatment after surgery should be carefully considered. Key Points • This study is the first to report the complications and systemic inflammatory responses after orthopedic surgery in patients treated with tofacitinib in comparison with matched pairs treated with conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) • While tofacitinib does not suppress postoperative increase in body temperature and CRP level, the postoperative decrease in lymphocyte count in patients treated with tofacitinib is significant compared with patients treated with csDMARDs • Attention should be paid to a reduced lymphocyte count when to resume tofacitinib after surgery.
(© 2021. International League of Associations for Rheumatology (ILAR).)
Erratum in: Clin Rheumatol. 2021 Nov 1;:. (PMID: 34724121)

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