OBJECTIVE: To examine the use of @entity1499 ( @entity1500 ) in @entity309 ( @entity309 ) @entity1 during the perioperative period. METHODS: Systematic review of studies retrieved by a sensitive search strategy in Medline (1961-July 2007), Embase (1961-July 2007), Cochrane Library (up to July 2007), and from the abstracts of the ACR (2005, 2006) and EULAR (2005-2007) annual scientific meetings. SELECTION CRITERIA: (population) studies had to include @entity1 with @entity309 undergoing surgery; (intervention and control) studies had to test continuing @entity1500 versus stopping @entity1500 ; and (outcomes), studies had to report complications within a year after the surgery including @entity281 , wound morbidity, surgery complications, and @entity309 flares. Only randomized controlled trials (RCT) or high quality cohort studies with a control group were included. RESULTS: @entity1 from the four included studies were mostly @entity1 with mean ages around 60. All of them underwent elective orthopaedic surgery and were taking @entity1500 doses mainly from 5 mg/week to 10 mg/week. By order of level of evidence, we found two RCTs, in which continuing on @entity1500 was not associated with increasing risk of surgery complications, but it was statistically associated with less @entity309 flares. In a prospective cohort study, four @entity281 were observed in the @entity1500 group while none were observed in the control group. No disease flare was reported in any group. A retrospective study showed that @entity1 on @entity1500 reported fewer cases of wound morbitity (p=0.038), @entity309 flares (p=0.050), and no differences related to @entity281 compared to those who stopped @entity1500 . CONCLUSIONS: Continuing with low doses of @entity1500 seems to be a safe option during the perioperative period in @entity309 @entity1 without relevant comorbidities and/or risk factors of @entity281 , undergoing elective orthopaedic surgery, while maintaining disease control.

A systematic review on the optimum management of the use of @entity1499 in @entity309 XXXX in the perioperative period to minimize perioperative morbidity and maintain disease control.

@entity1 :: ('9606', 'Species') :: ['women', 'Patients', 'patients'] @entity281 :: ('MESH:D007239', 'Disease') :: ['infections'] @entity1500 :: ('CHEBI:44185', 'Chemical') :: ['MTX'] @entity1499 :: ('MESH:D008727', 'Chemical') :: ['metho-trexate'] @entity309 :: ('MESH:D001172', 'Disease') :: ['rheumatoid arthritis', 'RA']
@entity1 :: (9606,Species) :: ['patients']
