Comment on: Complications and features after joint surgery in rheumatoid arthritis patients treated with tumour necrosis factor-alpha blockers: perioperative interruption of tumour necrosis factor-alpha blockers decreases complications?

摘要

Sir, We read with interest the recent article by Kawakami et al. [1] investigating the effects of perioperative interruption of anti-TNF therapy in patients with RA undergoing joint surgery in Japan. With rates of orthopaedic intervention in RA reportedly ranging from 17% in the first 5 years of disease [2] to as high as 58% within 20 years of diagnosis [3], we commend the authors for attempting to address such a pertinent question. We note, however, that a combination of the authors' definition of surgical site infection (SSI) and the methodology used within the study has a marked effect on the conclusions that can be drawn. Accordingly, their suggestion that anti-TNF therapy is a risk factor for post-operative SSI is overstated.