Do We Have to Stop Biologics before Surgery?

Abstract

The recent development of biological therapy has revolutionized care for patients with psoriasis, psoriatic arthritis, rheumatoid arthritis, and other diseases. Treatment with biologics can provide significant symptomatic and functional improvement. However, these agents have been associated with risks of compromised healing, such as infection, owing to their systemic blockade of mediators to the normal inflammatory responses required for tissue healing and immune surveillance. Given these potential risks and benefits, the question of how best to manage biologic therapy before planned surgery is an important consideration for practitioners. In an attempt to answer this question, we performed a review of the literature on this topic.