title: Safety of surgery in patients with rheumatoid arthritis treated by abatacept: data from the French Orencia in Rheumatoid Arthritis Registry.
abstract: To investigate the frequency and risk factors of postoperative complications in RA patients treated with abatacept (ABA).
  
  
  
  The Orencia RA registry recruited 1012 patients receiving ABA for RA in routine care. Data from patients treated with ABA who underwent surgery were reviewed to describe the frequency of postoperative complications. Characteristics of patients and surgeries with and without complications were compared to identify factors associated with complications.
  
  
  
  We identified 205 (20.3%) patients who underwent 263 surgeries, including 176 (66.9%) orthopaedic surgeries. Nineteen (7.2%) surgeries, in 19 patients (9.3%), entailed complications, including 7 delayed wound healing (2.7% of surgeries) and 6 surgical site infections (2.3% of surgeries). The median time between the last infusion of ABA and surgery was 5.9 weeks (range: 0.3-12.0 weeks), with no significant difference between patients with and without complications. The median corticosteroids daily dosage was higher in the group with complications [10.0 (6.25-15.0) vs 6.0 (5.0-10.0) mg/day, P = 0.042]. In multivariate analysis, only the duration of ABA treatment was significantly associated with postoperative complications [adjusted odds ratio (aOR) = 0.94 (95% CI: 0.89, 0.99) for each month of treatment], as were orthopaedic surgeries compared with other kinds of surgery [aOR = 4.45 (95% CI: 1.01, 20.2)].
  
  
  
  In RA patients treated with ABA, the rate of surgical complications was low: 7.2% and higher in case of orthopaedic procedure and a more recent initiation of ABA. The median time between surgery and the last infusion of ABA was short and did not influence the rate of postoperative complications.
authors.affiliation: Department of Rheumatology, Hôpitaux Universitaires Paris-Sud, Assistance Publique-Hôpitaux de Paris, Le Kremlin Bicêtre.|Department of Rheumatology, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Paris.
authors.forename: Augustin
authors.initials: A
authors.lastname: Latourte
authors.affiliation: Centre National de Référence des Maladies Auto-Immunes Rares, Fédération de Médecine Translationelle de Strasbourg, University Hospital of Strasbourg, Strasbourg University, Strasbourg.
authors.forename: Jacques-Eric
authors.initials: JE
authors.lastname: Gottenberg
authors.affiliation: Rheumatology Center, Purpan Hospital, Paul Sabatier University, Toulouse.
authors.forename: Cécile
authors.initials: C
authors.lastname: Luxembourger
authors.affiliation: Centre de Recherche en Epidémiologie et Statistiques, INSERM U1153, Centre d'Épidémiologie Clinique, Hôpital Hôtel-Dieu, Assistance Publique-Hôpitaux de Paris (AP-HP), Descartes University, Paris.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Pane
authors.affiliation: Rheumatology Department, Henri Mondor Hospital, Créteil.
authors.forename: Pascal
authors.initials: P
authors.lastname: Claudepierre
authors.affiliation: Department of Rheumatology, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Paris.
authors.forename: Pascal
authors.initials: P
authors.lastname: Richette
authors.affiliation: Rheumatology Department, Hopital de la Conception, University of Marseille, Marseille.
authors.forename: Pierre
authors.initials: P
authors.lastname: Lafforgue
authors.affiliation: Rheumatology Department, Lapeyronie University Hospital, Montpellier University, Montpellier.
authors.forename: Bernard
authors.initials: B
authors.lastname: Combe
authors.affiliation: Rheumatology Center, Purpan Hospital, Paul Sabatier University, Toulouse.
authors.forename: Alain
authors.initials: A
authors.lastname: Cantagrel
authors.affiliation: Centre National de Référence des Maladies Auto-Immunes Rares, Fédération de Médecine Translationelle de Strasbourg, University Hospital of Strasbourg, Strasbourg University, Strasbourg.
authors.forename: Jean
authors.initials: J
authors.lastname: Sibilia
authors.affiliation: Rheumatology Department, CHRU de Lille, Université de Lille-2, Lille.
authors.forename: René-Marc
authors.initials: RM
authors.lastname: Flipo
authors.affiliation: Rheumatology Department, CHU Grenoble, Grenoble.
authors.forename: Philippe
authors.initials: P
authors.lastname: Gaudin
authors.affiliation: Rheumatology Department, Rouen University Hospital & Inserm U905, Rouen.
authors.forename: Olivier
authors.initials: O
authors.lastname: Vittecoq
authors.affiliation: Rheumatology Department, Hôpital Pellegrin, CHU Bordeaux, Bordeaux.
authors.forename: Thierry
authors.initials: T
authors.lastname: Schaeverbeke
authors.affiliation: Department of Rheumatology - Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris Descartes University.|INSERM (U1153): Clinical epidemiology and biostatistics, PRES Sorbonne Paris-Cité.
authors.forename: Maxime
authors.initials: M
authors.lastname: Dougados
authors.affiliation: Inflammation-Immunopathology-Biotherapy Department (I2B), Saint-Antoine Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris 06, Paris, France.
authors.forename: Jeremie
authors.initials: J
authors.lastname: Sellam
authors.affiliation: Centre de Recherche en Epidémiologie et Statistiques, INSERM U1153, Centre d'Épidémiologie Clinique, Hôpital Hôtel-Dieu, Assistance Publique-Hôpitaux de Paris (AP-HP), Descartes University, Paris.
authors.forename: Philippe
authors.initials: P
authors.lastname: Ravaud
authors.affiliation: Department of Rheumatology, Hôpitaux Universitaires Paris-Sud, Assistance Publique-Hôpitaux de Paris, Le Kremlin Bicêtre.
authors.forename: Xavier
authors.initials: X
authors.lastname: Mariette
authors.affiliation: Department of Rheumatology, Hôpitaux Universitaires Paris-Sud, Assistance Publique-Hôpitaux de Paris, Le Kremlin Bicêtre.
authors.forename: Raphaèle
authors.initials: R
authors.lastname: Seror
mesh_terms: D000069594:Abatacept / Q000009:adverse effects*; D018501:Antirheumatic Agents / Q000008:administration & dosage*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000009:adverse effects; D061214:Patient Safety; D011183:Postoperative Complications / Q000139:chemically induced*; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000139:chemically induced; D013997:Time Factors; D014945:Wound Healing / Q000187:drug effects
chemical_list: D018501:Antirheumatic Agents; D000069594:Abatacept
keywords: abatacept; biologic agent; rheumatoid arthritis; safety; surgery