Patients with rheumatoid arthritis on biologics or other modern therapies who need major surgery may not be at any higher risk than those on methotrexate, a US study shows.

But being on moderate or high doses of corticosteroids puts people with rheumatoid arthritis (RA) needing surgery at higher risk of postoperative mortality or acute hospital readmission, the researchers say.

The results suggest that there may be no need to stop biologic therapy before major surgery, but that reducing corticosteroids preoperatively is important, the authors report in Annals of the Rheumatic Diseases.

Data from nearly 11,000 people with RA (mean age 72, 80% female) in a US Medicare database who had major surgery between 2007 and 2015 were used in the analysis.