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The British Journal of Rheumatology, Vol 36, 1009-1011, Copyright © 1997 by British Society for Rheumatology

ORIGINAL PAPERS

Perioperative use of methotrexate--a survey of clinical practice in the UK

A Steuer and AC Keat
Department of Rheumatology, Northwick Park and St Mark's Hospital, Harrow.

We have surveyed the use of methotrexate in the perioperative period in patients with rheumatoid arthritis (RA) undergoing surgery. A total of 200 consultant rheumatologists and 200 consultant orthopaedic surgeons in the UK were sent a postal questionnaire. Thirty-five per cent of rheumatologists and 46% of orthopaedic surgeons were concerned that the drug may increase the risk of post-operative complications, although significantly less 'always' stopped the drug around the time of surgery. There was great variation in the timing of stopping the drug with most stopping treatment within 2 weeks before surgery and restarting within 2 weeks after surgery. The majority of clinicians surveyed (70%) felt that national guidelines for the perioperative use of methotrexate would be helpful.
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