Surgery whilst on Bio treatments for psoriasis

[Fred]

This little study ahead of publication looks at the increased risk of post-operative complications whilst using Bio treatments for psoriasis and psoriatic arthritis.

Quote:

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Background:
There is limited evidence as to whether biologic therapy should be stopped or continued in patients with psoriasis and/or psoriatic arthritis (PsA) who are undergoing surgical procedures. Current guidelines of care recommend a planned break from biologic therapy in those undergoing major surgical procedures.

Objective:
To audit current practice of managing biologic therapy peri-operatively in a tertiary referral psoriasis clinic against guidelines of care and to investigate the effects of continuing/stopping biologic therapy in psoriasis and PsA patients.

Methods:
A retrospective audit of psoriasis and PsA patients who had a surgical procedure whilst on biologic therapy. A proforma was used to collect information on the biologics used, whether they were stopped peri-operatively and whether patients developed post-operative complications and/or disease flare.

Results:
A total of 42 patients who had 77 procedures were identified. Procedures ranged from skin surgery to orthopaedic and cardiothoracic surgery. Biologic therapy was continued in the majority of procedures (76%). There was no significant difference in post-operative risk of infection and delayed wound healing between those patients who continued and those who stopped biologic therapy, including those undergoing major surgery. Interrupting biologic therapy peri-operatively was associated with a significant (P = 0.003) risk of flare of psoriasis or PsA.

Conclusion:
Continuing biologic therapy in psoriasis and PsA patients peri-operatively did not increase the risk of post-operative complications. Interrupting biologic therapy peri-operatively significantly increased the risk of disease flare. This study is limited by cohort size and requires replication, ideally in a prospective randomized controlled manner.

Source: onlinelibrary.wiley.com

*Early version ahead of publication, no funding known.

[jiml]

A very interesting study that will be a great help for patients to bring to the attention  of medical staff at pre operative assessment when they suggest stopping which they invariably will as it's the easy option for them
What is needed now is a larger study to confirm the findings  

[Fred]

A very interesting study that will be a great help for patients to bring to the attention  of medical staff at pre operative assessment when they suggest stopping which they invariably will as it's the easy option for them
What is needed now is a larger study to confirm the findings  

Yes and also reassuring, especially for those on Stelara as it's three months between shots. So should you need urgent treatment like I did once to have the veins in my legs removed, they would be able to go ahead. (I wasn't on Bio's then but it would have been a worry waiting.)    

[mataribot]

There isn't any evidence to support that biologics, specially anti TNF, make anyone's cold or infection worse, besides a handful of already known infections.

[Caroline]

So this leads to the fact that this is an important post.

[Fred]

So this leads to the fact that this is an important post.

Yes it is important as there is so much put about how Bio's weaken your immune system (they do) but the way it's put about is always as if it's happening to everyone all the time.

What it says is "You're not going to shrivel up and die just because you're taking a Bio".