Evidence map›Paper›PMID 34545450›Full record

ArticleClinical rheumatology2021

Systemic inflammatory responses after orthopedic surgery in patients with rheumatoid arthritis treated with tofacitinib.

Akihiro Uchio, Takumi Matsumoto, Yuji Maenohara, Yasunori Omata, Hiroshi Takahashi, Mitsuyasu Iwasawa, Takuo Juji, Ichiro Nakamura, Sakae Tanaka

Erratum issuedAbstract read
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In one paragraph

Article in Clinical rheumatology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.2field-weighted citation impact, top 47% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 1 country.

Akihiro UchioDepartment of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
Takumi MatsumotoDepartment of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. matumot-tky@umin.ac.jp.ORCID http://orcid.org/0000-0003-2363-9803
Yuji MaenoharaDepartment of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
Yasunori OmataDepartment of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
Hiroshi TakahashiDepartment of Rheumatology, JCHO Yugawara Hospital, 2-21-6 Chuo, Yugawara, Ashigara-shimo, Kanagawa, 259-0396, Japan.
Mitsuyasu IwasawaDepartment of Orthopaedic Surgery, National Hospital Organization, Sagamihara Hospital, 18-1 Sakuradai, Minami-ku, Sagamihara City, Kanagawa, 252-0314, Japan.
Takuo JujiDepartment of Rheumatology, JCHO Yugawara Hospital, 2-21-6 Chuo, Yugawara, Ashigara-shimo, Kanagawa, 259-0396, Japan.
Ichiro NakamuraDepartment of Rheumatology, JCHO Yugawara Hospital, 2-21-6 Chuo, Yugawara, Ashigara-shimo, Kanagawa, 259-0396, Japan.
Sakae TanakaDepartment of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.ORCID http://orcid.org/0000-0001-9210-9414
The University of Tokyo · JPNational Sagamihara Hospital · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo investigate the acute phase response to surgical stress in patients with rheumatoid arthritis (RA) treated with tofacitinib, a Janus kinase (JAK) inhibitor.

methodsA retrospective matched pair analysis of 34 patients treated with tofacitinib and 34 patients treated with conventional disease-modifying anti-rheumatic drugs (csDMARDs) was performed. Patients were matched for age, sex, and type of surgery; body temperature, C-reactive protein (CRP) level, and white blood cell (WBC) count, neutrophil count, and lymphocyte count were compared between the tofacitinib and csDMARDs groups within 2 weeks after orthopedic surgery. Postoperative complications within 90 days were also assessed.

resultsNo surgical site infection or delayed wound healing was observed in the tofacitinib group; whereas, one case of superficial infection was noted in the csDMARDs group. A similar postoperative increase in body temperature and CRP level was observed in both the groups. Postoperatively, the tofacitinib group showed an increase in WBC and neutrophils counts and a decrease in lymphocyte count, unlike the csDMARDs group. In contrast to two patients (2.6%) in the csDMARDs group, seven patients (20.6%) in the tofacitinib group had lymphocyte counts below 500 cells/μL within 2 weeks postoperatively.

conclusionTofacitinib did not suppress postoperative increase in body temperature and CRP level. Because of the postoperative decrease in lymphocyte count in patients treated with tofacitinib, the timing for resuming tofacitinib treatment after surgery should be carefully considered. Key Points • This study is the first to report the complications and systemic inflammatory responses after orthopedic surgery in patients treated with tofacitinib in comparison with matched pairs treated with conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) • While tofacitinib does not suppress postoperative increase in body temperature and CRP level, the postoperative decrease in lymphocyte count in patients treated with tofacitinib is significant compared with patients treated with csDMARDs • Attention should be paid to a reduced lymphocyte count when to resume tofacitinib after surgery.

Indexed as

Antirheumatic AgentsArthritis, RheumatoidOrthopedic ProceduresHumansInfant, NewbornPiperidinesPyrimidinesPyrrolesRetrospective StudiesTreatment OutcomeAntirheumatic AgentsPiperidinesPyrimidinesPyrrolestofacitinibSurgerySystemic inflammatory responseTofacitinib

Identifiers

PMID34545450
OpenAlexW3199288664

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.