RESEARCH - Lack of increase in postoperative complications with low-dose MTX in patients with RA

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Mod Rheumatol. 2006;16(1):14-9.

Lack of increase in postoperative complications with low-dose methotrexate

therapy in patients with rheumatoid arthritis undergoing elective orthopedic

surgery.

Department of Orthopaedic Surgery, Kyoto University Graduate School of

Medicine, Kyoto, Japan. kchm@...

To determine the potential contribution of intermittent low-dose

methotrexate (MTX) treatment (2-8 mg/week) to postoperative complications,

we studied 122 patients with rheumatoid arthritis (RA) who had 201 surgical

procedures. The patients with treatment with MTX were allocated to two

groups: those who continued MTX (group A, 77 procedures) and those who

discontinued MTX more than 1 week (group B, 21 procedures). The patients who

had no treatment with MTX were allocated to group C (103 procedures). The

incidence of postoperative infection, poor wound healing, and flare-up of RA

was compared between the three groups. Postoperative infection occurred in

3.9%, 4.8%, and 3.9% in groups A, B, and C, respectively. Poor wound healing

was experienced in 1.3%, 9.5%, and 7.8% in groups A, B, and C, respectively.

At 4 weeks postoperatively, 3.9%, 14.3%, and 6.8% of flares were seen in

groups A, B, and C, respectively. No significant difference was found in the

patients with or without perioperative use of MTX. From these results, it is

unlikely that continuation of intermittent low-dose MTX treatment increases

the risk of postoperative complications in patients with RA. Continued

treatment with MTX during perioperative period could suppress disease

flares, especially in severe RA patients.

PMID: 16622718

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed & cmd=Retrieve & dopt=Abstra\

ctPlus & list_uids=16622718

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