Table 1.

Perioperative management of antirheumatic medications [15]

DMARDs (continue through surgery)	Dosing cycle
Methotrexate	Weekly
Sulfasalazine	Daily or twice daily
Hydroxycholorquine	Daily or twice daily
Leflunomide	Daily
Doxycycline	Daily
Biologic agents (stop prior to surgery, schedule surgery at end of dosing cycle)
Adalimumab (Humira)	Weekly or every other week
Etanercept (Enbrel)	Weekly or twice weekly
Golimumab (Simponi)	Every 4 weeks (SQ) or every 8 weeks (IV)
Infliximab (Remicade)	Every 4, 6, or 8 weeks
Abatacept (Orencia)	Monthly (IV) or weekly (SQ)
Certolizumab (Cimzia)	Every 2 or 4 weeks
Rituximab (Rituxan)	2 doses 2 weeks apart every 4–6 months
Tocilizumab (Actemra)	Weekly (SQ) or every 4 weeks (IV)
Anakinra (Kineret)	Daily
Secukinumab (Cosentyx)	Every 4 weeks
Ustekinumab (Stelara)	Every 12 weeks
Belimumab (Benlysta)	Every 4 weeks
Tofacitinib (Xeljanz)	Daily or twice daily	*Stop 7 days before surgery

DMARDs disease-modifying antirheumatic medications