Perioperative use of b/tsDMARDs
Australia & New Zealand Musculoskeletal Clinical Trials Network (ANZMUSC), 2023
For people taking targeted-synthetic DMARDs, consider temporarily pausing the drug before and after major surgery. The duration of the pause varies by patient, type of surgery and drug; discuss with the treating specialist. Biological DMARDs should not be paused routinely for surgery, but may be paused temporarily for surgery with a high risk of infection or where the impact of infection would be severe.
For a minor procedure (eg dental extraction, skin-lesion removal, biopsy), a b/tsDMARD does not need to be paused.
Advice about perioperative use of b/tsDMARDs in RA is available from An Australian Living Guideline for the Pharmacological Management of Inflammatory Arthritis: Perioperative use of DMARDs in people with inflammatory arthritis1.