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Contact the study team using the details below to take part. If there are no contact details below please ask your doctor in the first instance.
Dr
Samantha
Brady
samantha.gascoyne@york.ac.uk
More information about this study, what is involved and how to take part can be found on the study website.
Rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis, forms of inflammatory arthritis
This information is provided directly by researchers, and we recognise that it isn't always easy to understand. We are working with researchers to improve the accessibility of this information. In some summaries, you may come across links to external websites. These websites will have more information to help you better understand the study.
Rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis are common forms of inflammatory arthritis. They are caused by an overactive immune system and are treated with medicines that reduce pain and inflammation. In recent years, special immune-suppressing medicines, called biologics, have been developed, which are very effective in controlling the arthritis disease process and symptoms but can increase the risk of some infections. People with inflammatory arthritis often need orthopaedic surgery (e.g. joint replacement) to relieve pain and improve function due to the damage caused by arthritis. The potential for increased risk for surgical site infections is a particular concern for patients undergoing orthopaedic surgery as these can be associated with long-term pain and the need for further surgery. Currently, biologics are usually stopped before any planned operation to try and reduce the risk of infection and other complications such as slow wound healing. However, stopping biologics increases the risk of painful and debilitating flares and delays recovery from surgery. Flares are often treated with steroids, which can increase the infection risk and delay wound healing. There are no randomised trials to support the current guidance on stopping biologics before surgery.
Start dates may differ between countries and research sites. The research team are responsible for keeping the information up-to-date.
The recruitment start and end dates are as follows:
2024 Protocol article in https://pubmed.ncbi.nlm.nih.gov/38910007/ (added 25/06/2024)
You can take part if:
Current inclusion criteria as of 11/10/2024:
1. Adults aged 18 years and over with RA, PsA, or AS (including juvenile onset of all three)
2. Currently prescribed one of the following bDMARDs: TNF inhibitors (e.g. adalimumab /etanercept/ golimumab/certolizumab pegol/infliximab); CTLA4-Ig (e.g. abatacept); IL-6 inhibitors (e.g. tocilizumab/sarilumab); IL-12/23 inhibitors (e.g. ustekinumab); IL-17 inhibitors (e.g. secukinumab/ixekizumab); IL-23 p19 inhibitors (e.g. guselkumab/risankizumab).
3. Deemed by the clinical care team to be fit for surgery and have no contraindications to continued bDMARD use
4. Scheduled to undergo elective orthopaedic surgery (Soft tissue, metalwork, or Joint replacement)
5. Able to consent and complete
You may not be able to take part if:
Current exclusion criteria as of 13/08/2025:
1. Currently prescribed JAK inhibitors2. Currently being treated with rituximab3. Current use of systemic steroids (< 3 months of surgery date) other than those on a stable dose of <= 15mg per day4. Previous history of native/prosthetic joint infection5. Undergoing revision surgery6. Patients who are pregnant
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Previous exclusion criteria:
1. Currently prescribed JAK inhibitors2. Currently being treated with rituximab3. Current use of systemic steroids (< 3 months) other than those on a stable dose of < = 5mg per day4. Previous history of native/prosthetic joint infection5. Undergoing revision surgery6. Patients who are pregnant
Below are the locations for where you can take part in the trial. Please note that not all sites may be open.
Dr
Samantha
Brady
samantha.gascoyne@york.ac.uk
More information about this study, what is involved and how to take part can be found on the study website.
The study is sponsored by University of Leeds and funded by National Institute for Health and Care Research.
Your feedback is important to us. It will help us improve the quality of the study information on this site. Please answer both questions.
Or CPMS: 55648
You can print or share the study information with your GP/healthcare provider or contact the research team directly.
