title: Safety of surgery after rituximab therapy in 133 patients with rheumatoid arthritis: data from the autoimmunity and rituximab registry.
abstract: OBJECTIVE
  We used data from the AutoImmunity and Rituximab (AIR) registry to investigate the safety of surgery for patients with rheumatoid arthritis receiving rituximab (RTX) in routine care.
  
  
  METHODS
  Data for patients included in the AIR registry and undergoing surgery during the year following an infusion of RTX were reviewed to describe the frequency of postsurgical complications, compare patients with and without complications, and identify factors associated with complications.
  
  
  RESULTS
  We examined data for 133 patients with a known date of surgery and at least 1 followup visit, corresponding to 140 procedures, including 94 orthopedic surgeries (67%) and 23 abdominal surgeries (16.5%). The median delay between surgery and the last RTX infusion was 6.4 months (interquartile range 4.3– 8.7 months), without any difference between patients with and without complications. Nine patients (6.7%) experienced 12 complications (8.5%), including 8 surgical site infections (5.7%) and 1 death due to septic shock. Postoperative complications occurred after 4.3% of abdominal surgeries (1 of 23) and 7.4% of orthopedic surgeries (7 of 95). On univariate analysis, spine surgery was associated with postoperative complications (P = 0.048).
  
  
  CONCLUSIONS
  In common practice, the risk of complications may be more important in case of spine surgery, but does not seem to be linked to the time between the last RTX infusion and surgery.
authors.forename: S
authors.initials: S
authors.lastname: Godot
authors.forename: J-E
authors.initials: JE
authors.lastname: Gottenberg
authors.forename: S
authors.initials: S
authors.lastname: Paternotte
authors.forename: I
authors.initials: I
authors.lastname: Pane
authors.forename: B
authors.initials: B
authors.lastname: Combe
authors.forename: J
authors.initials: J
authors.lastname: Sibilia
authors.forename: R-M
authors.initials: RM
authors.lastname: Flipo
authors.forename: T
authors.initials: T
authors.lastname: Schaeverbeke
authors.forename: P
authors.initials: P
authors.lastname: Ravaud
authors.forename: E
authors.initials: E
authors.lastname: Toussirot
authors.forename: F
authors.initials: F
authors.lastname: Berenbaum
authors.forename: X
authors.initials: X
authors.lastname: Mariette
authors.forename: D
authors.initials: D
authors.lastname: Wendling
authors.forename: J
authors.initials: J
authors.lastname: Sellam
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy / Q000276:immunology / Q000601:surgery; D015551:Autoimmunity; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006801:Humans; D007155:Immunologic Factors / Q000008:administration & dosage; D015994:Incidence; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000517:prevention & control; D011379:Prognosis; D011446:Prospective Studies; D012042:Registries; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D000069283:Rituximab; D013514:Surgical Procedures, Operative; D016896:Treatment Outcome
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D007155:Immunologic Factors; D000069283:Rituximab