Surgery & Baracitinib

[Inanotherlife]

Good morning,

I hope everyone is enjoying the warmer weather, I always feel a bit better seeing some sunshine…

Anyone had experience of having surgery whilst taking Baracitinib? Just asking in terms of how they managed without it?

I have ankle surgery soon and understand I need to stop the drug prior to that and then restart once the wound has healed.

Thanks in anticipation x

[Madmusiclover]

Yes. I’ve had three ops I’ve had to stop for. It was not too bad though sadly now flaring on it. Thankfully you don’t have to come off it for too long. Coming off HRT was much worse!

[Inanotherlife in reply to Madmusiclover]

thank you, sorry you’re flaring, it’s a pain of a disease isn’t it!

It was mentioned that I may have to stop my HRT too for the op because of the blood clot risk so that adds another layer to deal with. I hope things settle soon x

[Amnesiac3637]

Hi, yes had hip replacement in August 2021 whilst on Baricitinib. Had to stop two weeks prior to surgery on surgeon’s instructions (rheumatology consultant happy for only a week) and was off it for two weeks afterwards.

I was fine and didn’t flare at all during that time. I am on Prednisolone tho and the anaesthetist would have given me a booster dose so that probably helped me not to have joint pain while I was off the drug.

I had to stop Baricitinib after I contracted Covid in February 2022 which was a real shame as it was working so well for me but it just seemed to switch off.

Best of luck with your op and restarting on Baricitinib!

[Inanotherlife in reply to Amnesiac3637]

thank you, shame Covid seemed to stop it working. I hope you’re feeling the benefit of whatever you take currently.

I’m only having keyhole surgery so hoping the wounds won’t take long to heal and I can restart it because if I happen to miss just a day, I can feel it..

[Mmrr]

I was taking toficitinib and leflunomide and advised by rheumatologist to stop both a week before having a microdiscectomy.The neurosurgeon advised to stay on both meds as a the risk of a flare was high, and flaring prevents healing too. As for the risk of infection after surgery / wound not healing well...it runs about 3 - 5 % for non immunosuppressed people and around 5 - 8 % for immunosuppressed people, so depending upon which research you accept, the risk of infection is no greater after surgery for the immunosuppressed. He rheumatologist could not quote any research or specific healings risks to me. The figures apply to clean surgery only....opening the abdominal cavity is quite different.

I chose to follow the neurosurgeons advice and research figures, stayed on all meds, was given a double dose of steroids on the day of surgery (I take oral prednisolone every day) and had no problems at all. The wound took a bit longer than normal to heal, but healed well, and I didn't flare.

[Inanotherlife in reply to Mmrr]

thank you, that’s interesting and good to know. I’ve since heard back from Rheumatology who said stop for 2 weeks before and after but I only have 1 week now anyway. Also, another anomaly, the surgeon said I was fine to stay on HRT but the nurse on the pre op for the hospital said otherwise due to blood clot risk.

[Mmrr]

I'm not sure how long you have been diagnosed, but you will find anomalies between the information provided regularly by the medical profession. I tend to listen what is being said, then research it out, ask on the forum and come to my own decisions. Then let whoever needs to know, know.

I love your forum name btw 😊

[Inanotherlife in reply to Mmrr]

I think you’re absolutely right, you have to be your own advocate with this. Another area I’d like a more consistent approach to is Probiotics. I’ve had nurses, consultants and pharmacists give differing responses when asking about taking them with RA drugs.

I was diagnosed 10 years ago more or less to the day, I was 38. Had never even heard of it…

Hope you are enjoying the sunshine 😊