Conventional and Biological DMARDs in Systemic Rheumatic Diseases: Perioperative Risk/Benefit Management

Systemic rheumatic diseases are lifelong in nature and are often associated with comorbidities requiring surgery at a time when many patients are receiving immunosuppressive therapy. The main surgical complications in such cases are impaired wound healing and infective events. The perioperative phase needs to be carefully managed, with the close collaboration of rheumatologists and surgeons. This chapter reviews the principal published evidence concerning the perioperative phase of surgery in patients with systemic rheumatic disease being treated with conventional synthetic or biologic disease-modifying antirheumatic drugs.