Perioperative immunosuppressive use in patients with rheumatologic diseases
Effective and safe perioperative immunosuppressive management for patients with rheumatic diseases is often challenging and complex. Immunosuppressive agents result in decreased immunity, thus increasing the risk of infection, and its anti-inflammatory effect hinders the tissue healing process. The difficulty of the clinical decision-making regarding the safe management of these agents in the perioperative period arises from the need to conciliate several outcomes: ensure adequate clinical control of the underlying rheumatic disease activity, while also aiming to mitigate the risk of perioperative complications, mostly minimizing the risk of impairment of the postoperative tissue healing as well as the risk of postoperative infection. In this review article, we will highlight the peri-operative immunosuppressive management and doses suggested for patients with rheumatic diseases.