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DOI: 10.1055/s-0030-1267181
© Georg Thieme Verlag KG Stuttgart · New York
Prä- und postoperatives Management von Patienten unter Rituximab-Therapie
Pre- and Postoperative Management of Patients Receiving Rituximab TherapyPublication History
Publication Date:
22 December 2010 (online)
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Zusammenfassung
Postoperative Wundheilungsstörungen oder Infekte wurden in unserem Patientenkollektiv unter Einsatz von Rituximab nicht beobachtet. Unter Berücksichtigung der Anzahl und der unterschiedlichen Schweregrade der operativen Eingriffe scheinen keine über das sonst übliche Ausmaß hinausgehende Vorsichtsmaßnahmen berücksichtigt werden zu müssen. Bei elektiven Operationen empfehlen wir ein Zeitintervall von 6 bis 9 Monaten nach der letzten RTX-Gabe.
Abstract
We have detected no problems in wound-healing or infections after operations under rituximab therapy in our patients. Further observations should be performed, as our database up to now is too small to give valid recommendations for a preoperative management of patients receiving RTX. Actually we prefer a time space of 6–9 months between elective operations and the last RTX infusion.
Schlüsselwörter
Operation - rheumatoide Arthritis - Rituximab
Key words
operation - rheumatoid arthritis - rituximab
Literatur
- 1 Cohen SB, Emery P, Greenwald MW. et al . Rituximab for rheumatoid arthritis refractory to anti-tumor necrosis factor therapy. Results of a multicenter, randomized, double-blind, placebo-controlled phase III trial evaluating primary efficacy and safety at 24 weeks. Arthritis Rheum. 2006; 54 2793-2806
- 2 Keystone E, Fleischmann RM, Emery P. et al . Repeated treatment courses of rituximab in rheumatoid arthritis: sustained efficacy in patients with an inadequate response to one or more TNF inhibitors. Ann Rheum Dis. 2007; 66 (Suppl. II) 432
- 3 Bibbo C, Goldberg JW. Infectious and healing complications after elective orthopaedic foot and ankle surgery during tumor necrosis factor-alpha inhibition therapy. Foot Ankle Int. 2004 May; 25 (5) 331-335
- 4 Busti AJ, Hooper JS, Amaya CJ. et al . Effects of perioperative antiinflammatory and immunmodulating therapy on surgical wound healing. Pharmacotherapy. 2005 Nov; 25 (11) 1566-1591
- 5 Den Broeder AA, Creemers MC, Fransen J. et al . Risk factors for surgical site infections and other complications in elective surgery in patients with rheumatoid arthritis with special attention for anti-tumor necrosis factor: a large retrospective study. J Rheumatol. 2007; 34 689-695
- 6 Fuerst M, Mohl H, Baumgartel K. et al . Leflunonomide increases the risk of early healing complications in patients with rheumatoid arthritis undergoing elective orthopaedic surgery. Rheumatol Int. 2006; 26 1138-1142
- 7 Grennan DM, Gray J, Loudon J. et al . Methotrexate and early postoperative complications in patients with rheumatoid arthritis undergoing elective orthopaedic surgery. Ann Rheum Dis. 2001; 60 214-217
- 8 Jain A, Witbreuk M, Ball C. et al . Influence of steroids and methotrexate on wound complications after elective rheumatoid hand and wrist surgery. J Hand Surg (Am). 2002; 27 449-455
- 9 Rosandich PA, Kelley 3rd JT, Conn DL. Perioperative management of patients with rheumatoid arthritis in the era of biologic response modifiers. Curr Opin Rheumatol. 2004 May; 16 (3) 192-198
- 10 Ruyssen-Witrand A, Gossec L, Salliot C. et al . Complication rates of 127 surgical procedures performed in rheumatic patients receiving tumor necrosis factor alpha blockers. Clin Exp Rheumatol. 2007 May–Jun; 25 (3) 430-436
- 11 Härtle P, Fleck M. Immunsuppressive Therapie bei Patienten mit rheumatischen Erkrankungen im Vorfeld elektiver Operationen. Arzneimitteltherapie. 2008; 26 332-336
- 12 Saech J, Maizus K, Owczarczyk K. et al .Kein erhöhtes Risiko für postoperative Infektionen unter Rituximab bei Patienten mit RA.. Poster, Deutscher Rheumatologenkongress Köln; 2009
Korrespondenzadresse
Dr. Martin Arbogast
Klinik für Rheumaorthopädie
und Handchirurgie
Rheumazentrum
Oberammergau
Hubertusstraße 40
82487 Oberammergau
Phone: +49/8822/914 311
Fax: +49/8822/914 162
Email: martin.arbogast@wz-kliniken.de