REVIEW - The place of MTX perioperatively in elective orthopedic surgeries in patients with RA

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Clin Rheumatol. 2008 Oct;27(10):1217-20. Epub 2008 Apr 15.

The place of methotrexate perioperatively in elective orthopedic

surgeries in patients with rheumatoid arthritis.

Pieringer H, Stuby U, Biesenbach G.

Section of Rheumatology, 2nd Department of Medicine, General Hospital

Linz, Krankenhausstr. 9, Linz, 4020, Austria.

No clear consensus exists on whether methotrexate (MTX) should be

continued or whether this therapy should be discontinued for a few

weeks in patients with rheumatoid arthritis (RA) undergoing surgery.

Continued MTX therapy may impair wound healing, but discontinuation of

the therapy may increase the risk of flares. In this article we review

published data on the perioperative management of MTX in patients with

RA undergoing elective orthopedic surgery. Eight papers on this topic

could be identified. These studies compare continued vs. discontinued

MTX therapy or MTX therapy vs. therapies other than MTX. Summing up

the published data, continued MTX therapy appears to be safe

perioperatively and seems also to be associated with a reduced risk of

flares. None of the examined papers addresses the issue of safety in

connection with comorbidities, age or high doses of MTX.

PMID: 18414965

http://www.ncbi.nlm.nih.gov/pubmed/18414965

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