ACR Meeting Abstracts

ACR Meeting Abstracts

  • Home
  • Meetings Archive
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018 ACR/ARHP Annual Meeting
    • 2017 ACR/ARHP Annual Meeting
    • 2017 ACR/ARHP PRSYM
    • 2016-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • Meeting Resource Center

Abstract Number: 1624

Safety of Surgery in Patients Treated with Tocilizumab for Rheumatoid Arthritis : Data from a French Registry

Marie Locci1, Bernard Combe2, Cédric Lukas3, Maxime Dougados4, Rene-Marc Flipo5, Christian Marcelli6, Stephanie Rist Bouillon7, Jean Sibilia8 and Jacques Morel9, 1rheumatology, CHU Lapeyronie, MONTPELLIER, France, 2Département Rhumatologie, Hôpital Lapeyronie, Montpellier, France, 3Rheumatology, CHU Lapeyronie and EA2415, Montpellier University, University of Montpellier, France, 4Rheumatology, Paris Descartes University, Paris, France, 5Rheumatology, University Hospital, Lille, France, 6Rheumatology dept, University Hospital Centre of Caen, Caen, France, 7Rhumatologie, Hopital La Source, La Source, France, 8Department of Rheumatology, Strasbourg University Hospital, Strasbourg, France, 9Rheumatology, Department of Rheumatology, Montpellier University Hospital, Montpellier, France

Meeting: 2016 ACR/ARHP Annual Meeting

Date of first publication: September 28, 2016

Keywords: Safety, surgery and tocilizumab

  • Tweet
  • Email
  • Print
Session Information

Date: Monday, November 14, 2016

Session Title: Rheumatoid Arthritis – Small Molecules, Biologics and Gene Therapy - Poster II

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose: Rheumatoid Arthritis (RA) patients have a higher risk of post-operative complications compared with the general population, especially considering the risk of infection. It remains unclear whether use of biological DMARDs, including Tocilizumab (TCZ), is an independent risk factor for post-operative complications. The aim of this study was to evaluate safety and predictive factors of complications after surgery in rheumatoid arthritis patients receiving Tocilizumab in routine care.

Methods: Patients treated with TCZ for RA included in the French REGATE registry were included if they underwent surgery. When TCZ was interrupted more than 12 weeks prior to surgery, patients were excluded. Post-operative complications were defined as an adverse event occurring in the 12 weeks after surgery. Frequency of post-surgery complications was collected and compared in patients with and without complications in order to identify factors associated with complications. A second analyze was achieved in patients with post-operative infection (local or general). Qualitative variables were compared by Fisher’s test and quantitative variables were compared by the Mann-Whitney test.

Results: Out of 1499 patients from the REGATE registry, a total of 167 patients underwent 175 surgical procedures. These patients were mainly women (84%), the mean age was 58.11 +/- 12.83 years, and the disease duration of 14.96+/- 11.29 years. The mean delay between surgery and the last TCZ infusion was 4.94+/-1.74 weeks (median 4 weeks). Fifteen patients experienced 15 complications (8.9%) with 10 severe infections, 1 intestinal obstruction, 1 RA flare, 1 delayed wound healing, 1 thromboembolic disorder and 1 hemorrhagic complication. Postoperative complications occurred after 7.8% of orthopedic surgeries (8 of 103). The 10 severe infections occurred mostly after orthopedic surgery (7/10). There was 7 surgical site infections (46.7%) and 3 general infections. In 5 patients, TCZ treatment was definitely stopped. On univariate analysis, no risk factor was significantly associated with post–operative complications. However, corticosteroids (p=0.096), previous biological treatment (p=0.096) and previous RTX treatment (p=0.074) almost reached statistically significancy.In multivariate analysis, only previous RTX treatment was close to be significant in multivariate analysis (OR: 3.27, IC95% 0.92-11.49, p=0.052). Concerning infectious complications, no risk factor was found statistically associated with post-operative complications on univariate analysis. Only diabetes mellitus (p=0.091), foot surgery (p=0.095) and number of TCZ infusions before surgery (p=0.084), were almost statistically significant. In multivariate analysis, only foot surgery (OR: 3.17, IC95% 0.82-12.21 p=0.078) and diabetes mellitus (OR: 3.73, IC95% 0.88-15.79, p=0.057) tended to be associated with infectious post-operative complications.

Conclusion:

In routine practice, the postoperative period in TCZ treated patients seem to be safe when TCZ is stopped 1 month before surgery. Diabetes was significantly associated with an increased risk of post-operative infection in RA patients treated with TCZ.


Disclosure: M. Locci, None; B. Combe, None; C. Lukas, None; M. Dougados, Pfizer, AbbVie, Celgene, Eli Lilly, Novartis, Roche, and Sanofi-Aventis, 5,Pfizer, AbbVie, UCB, Merck, 8; R. M. Flipo, None; C. Marcelli, None; S. Rist Bouillon, None; J. Sibilia, None; J. Morel, None.

To cite this abstract in AMA style:

Locci M, Combe B, Lukas C, Dougados M, Flipo RM, Marcelli C, Rist Bouillon S, Sibilia J, Morel J. Safety of Surgery in Patients Treated with Tocilizumab for Rheumatoid Arthritis : Data from a French Registry [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/safety-of-surgery-in-patients-treated-with-tocilizumab-for-rheumatoid-arthritis-data-from-a-french-registry/. Accessed May 26, 2022.
  • Tweet
  • Email
  • Print

« Back to 2016 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/safety-of-surgery-in-patients-treated-with-tocilizumab-for-rheumatoid-arthritis-data-from-a-french-registry/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

ACR Pediatric Rheumatology Symposium 2020

© COPYRIGHT 2022 AMERICAN COLLEGE OF RHEUMATOLOGY

Wiley

  • Home
  • Meetings Archive
  • Advanced Search
  • Meeting Resource Center
  • Online Journal
  • Privacy Policy
  • Permissions Policies
loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.