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This study evaluated the association between infliximab timing and serious infection after elective hip or knee arthroplasty.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective cohort study evaluated <jats:styled-content style=\"fixed-case\">US<\/jats:styled-content> Medicare patients with rheumatoid arthritis, inflammatory bowel disease, psoriasis, psoriatic arthritis, or ankylosing spondylitis who received infliximab within 6 months of elective knee or hip arthroplasty from 2007 to 2013. Propensity\u2010adjusted analyses examined whether infliximab stop timing (time between the most recent infusion and surgery) was associated with hospitalized infection within 30 days or prosthetic joint infection (<jats:styled-content style=\"fixed-case\">PJI<\/jats:styled-content>) within 1 year.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Hospitalized infection within 30 days occurred after 270 of 4,288 surgeries (6.3%). Infliximab stop timing &lt;4 weeks versus 8\u201312 weeks was not associated with an increase in infection within 30 days (propensity\u2010adjusted odds ratio [<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>] 0.90 [95% confidence interval (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>) 0.60\u20131.34]). The rate of <jats:styled-content style=\"fixed-case\">PJI<\/jats:styled-content> was 2.9 per 100 person\u2010years and was not increased in patients with stop timing &lt;4 weeks versus 8\u201312 weeks (hazard ratio [<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>] 0.98 [95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.52\u20131.87]). Glucocorticoid dosage &gt;10 mg\/day was associated with increased risk of 30\u2010day infection (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 2.11 [95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.30\u20133.40]) and <jats:styled-content style=\"fixed-case\">PJI<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content> 2.70 [95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.30\u20135.60]). Other risk factors for infection included elderly age, comorbidities, revision surgery, and previous hospitalized infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Administering infliximab within 4 weeks of elective knee or hip arthroplasty was not associated with a higher risk of short\u2010 or long\u2010term serious infection compared to withholding infliximab for longer time periods. Glucocorticoid use, especially &gt;10 mg\/day, was associated with an increased infection risk.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.23209","type":"journal-article","created":{"date-parts":[[2017,1,27]],"date-time":"2017-01-27T15:33:31Z","timestamp":1485531211000},"page":"1845-1854","source":"Crossref","is-referenced-by-count":77,"title":["Perioperative Timing of Infliximab and the Risk of Serious Infection After Elective Hip and Knee Arthroplasty"],"prefix":"10.1002","volume":"69","author":[{"given":"Michael D.","family":"George","sequence":"first","affiliation":[{"name":"University of Pennsylvania Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua F.","family":"Baker","sequence":"additional","affiliation":[{"name":"University of Pennsylvania and Philadelphia Veterans Affairs Medical Center Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesse Yenchih","family":"Hsu","sequence":"additional","affiliation":[{"name":"University of Pennsylvania Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qufei","family":"Wu","sequence":"additional","affiliation":[{"name":"University of Pennsylvania Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fenglong","family":"Xie","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lang","family":"Chen","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huifeng","family":"Yun","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey R.","family":"Curtis","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,11,2]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.22504"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.295.19.2275"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2011.152769"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2011-201108"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.22808"},{"key":"e_1_2_7_7_1","first-page":"689","article-title":"Risk factors for surgical site infections and other complications in elective surgery in patients with rheumatoid arthritis with special attention for anti\u2010tumor necrosis factor: a large retrospective study","volume":"34","author":"Den Broeder AA","year":"2007","journal-title":"J Rheumatol"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.24060"},{"key":"e_1_2_7_9_1","first-page":"430","article-title":"Complication rates of 127 surgical procedures performed in rheumatic patients receiving tumor necrosis factor alpha blockers","volume":"25","author":"Ruyssen\u2010Witrand A","year":"2007","journal-title":"Clin Exp Rheumatol"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2011-301495"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.22077"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-014-3121-0"},{"key":"e_1_2_7_13_1","first-page":"573","article-title":"Management of perioperative tumour necrosis factor \u03b1 inhibitors in rheumatoid arthritis patients undergoing arthroplasty: a systematic review and meta\u2010analysis","volume":"55","author":"Goodman SM","year":"2016","journal-title":"Rheumatology (Oxford)"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.23721"},{"key":"e_1_2_7_15_1","first-page":"1583","article-title":"Canadian Rheumatology Association recommendations for the pharmacological management of rheumatoid arthritis with traditional and biologic disease\u2010modifying antirheumatic drugs","volume":"39","author":"Bombardier C","year":"2012","journal-title":"Part II: safety. 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