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Safety of surgery in patients with rheumatoid arthritis treated with tocilizumab: data from the French (REGistry –RoAcTEmra) Regate registry

1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13

 

  1. Rheumatology Department, CHU and Montpellier University, France. j-morel@chu-montpellier.fr
  2. Rheumatology Department, CHU and Montpellier University, France.
  3. Rheumatology Department, Hôpital d’Instruction des Armées Legouest, Metz, France.
  4. Rheumatology Department, CHU and Montpellier University, France.
  5. Rheumatology Department, CHD Vendée, La Roche sur Yon, France.
  6. Department of Rheumatology, Paris Descartes University, Hôpital Cochin; Assistance Publique, Hôpitaux de Paris; INSERM (U1153): Clinical Epidemiology and Biostatistics, PRES Sorbonne Paris-Cité, Paris, France.
  7. Rheumatology Department, Hôpital Roger Salengro, CHRU Lille, Lille Université 2, France.
  8. Rheumatology Department, CHU Côte de Nacre, Caen, France.
  9. Rheumatology Department, APHM, CHU Sainte Marguerite, Aix-Marseille Univ, Marseille, France.
  10. Department of Rheumatology, CHR Orléans, France.
  11. Rheumatology Department, CHU La Miletrie, Poitiers, France.
  12. Rheumatology Department, Hôpital de Hautepierre, Strasbourg, France.
  13. Rheumatology Department, CHU and Montpellier University, France.

CER12032
2020 Vol.38, N°3
PI 0405, PF 0410
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PMID: 31969215 [PubMed]

Received: 30/12/2018
Accepted : 21/06/2019
In Press: 20/01/2020
Published: 26/05/2020

Abstract

OBJECTIVES:
To investigate the frequency and risk factors of postoperative complications in RA patients treated with tocilizumab (TCZ).
METHODS:
The French registry REGATE recruited 1496 RA patients receiving TCZ in routine care. Data from patients treated with TCZ who underwent surgery were reviewed. Frequency of post-surgery complications was collected and compared in patients with and without complications in order to identify factors associated with complications. Similar analysis was performed in patients with postoperative infection.
RESULTS:
We identified 167 patients who underwent 175 surgical procedures including 103 orthopaedic surgeries (58.9%). The patients were mainly women (84%) with a mean disease duration of 14.96±11.29 years. The mean delay between surgery and the last TCZ infusion was 4.94±1.74 weeks. Fifteen patients experienced 15 complications (8.6%) with 10 severe infections including 5 surgical site infections (33.3%). There was no significant difference between patients with and without complications. In multivariate analysis, previous treatment with rituximab in the previous year tended to be associated with postoperative complications (OR: 3.27, IC95% 0.92–11.49, p=0.06). Concerning postoperative infections, diabetes mellitus tended to be associated with this complication (OR: 3.73, IC95% 0.88–15.79, p=0.06) in multivariate analysis.
CONCLUSIONS:
In RA patients treated with TCZ in perfusion, the rate of surgical complications was low: 8.6%. The median time between surgery and last infusion was relatively short according to half-life of TCZ but did not influence the rate of postoperative complications.

Rheumatology Article

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