Treatment
Table 3. Populations Included in the Guideline
Populations
a
Adults age ≥18 years diagnosed with rheumatoid arthritis, spondyloarthritis including
ankylosing spondylitis and psoriatic arthritis, juvenile idiopathic arthritis, or SLE (see
below), who are deemed to be appropriate surgical candidates, undergoing elective total
hip arthroplasty or total knee arthroplasty, and who are treated with antirheumatic drug
therapy at the time of surgery.
SLE
SLE includes patients with severe or not severe SLE (defined below), and who are in
optimal condition for surgery:
Severe SLE
Currently treated (induction or maintenance) for severe organ manifestations:
lupus nephritis, central nervous system lupus, severe hemolytic anemia (hemoglobin
<9.9 g/dL), platelets <50,000/mL, vasculitis (other than mild cutaneous vasculitis),
including pulmonary hemorrhage, myocarditis, lupus pneumonitis, severe myositis
(with muscle weakness, not just high enzymes), lupus enteritis (vasculitis), lupus
pancreatitis, cholecystitis, lupus hepatitis, protein-losing enteropathy, malabsorption,
orbital inflammation/myositis, severe keratitis, posterior severe uveitis/retinal vasculitis,
severe scleritis, optic neuritis, anterior ischemic optic neuropathy (derived from the
SELENA–SLEDAI Flare Index and BILAG 2004).
Not severe SLE
Not currently treated for manifestations listed under Severe SLE.
a
All patients carrying the diagnoses listed, without restriction to those meeting diagnostic or
classification criteria.
