New Guidelines Issued on Antirheumatic Drugs for Patients Undergoing Knee or Hip Replacement — Physician’s First Watch
New Guidelines Issued on Antirheumatic Drugs for Patients Undergoing Knee or Hip Replacement
By Kelly Young
Edited by Susan Sadoughi, MD
The American College of Rheumatology and the American Association of Hip and Knee Surgeons have released new guidelines on managing the antirheumatic medications of patients with rheumatic diseases who are undergoing elective total knee or hip arthroplasty.
The guidelines, which are available for free in Arthritis Care & Research, include seven recommendations that are based on low-to-moderate quality of evidence. Among them:
Patients can continue taking non-biologic disease-modifying antirheumatic drugs (e.g., methotrexate, leflunomide, hydroxychloroquine, sulfasalazine) during the perioperative period.
Biologic medications (e.g., adalimumab, etanercept) should be withheld for about one dosing schedule before elective surgery. They can be resumed once there is evidence of wound healing — a minimum of 14 days.