When to stop biologics

MissA

I have been given conflicting advice on when I should stop taking my weekly TOCILIZUMAB injections prior to my second TKR operation due 7/10/25.

2 years ago my rheumatology consultant said stop my biologics 4 weeks prior to my first TKR operation. I wanted to clarify the timing for my upcoming op & have a different consultant, when I asked he went on to the internet & said 1 week before op! Seeing him scroll through the internet didn’t fill me with confidence & when he said 1 week I was not convinced this was right, based on my previous consultants advice.

Does anyone know if the rules have changed in the past 2 years? I know medical advice can alter with new research etc.

jamieA

Hi @MissA

I'd go back and ask for a clarification from your rheumatologist. The VA website states 4 weeks https://versusarthritis.org/about-arthritis/treatments/drugs/tocilizumab/ . I'd also suggest that you ask rheumatology to speak to your orthopaedics consultant to clarify your particular situation. In my experience there appears to be no communication between the different disciplines within the NHS with regards to individual patients and their circumstances.

SharminB

Hi @MissA , thank you for sharing her on the online community 😊

Here’s some information from our website, which says if you’re taking tocilizumab intravenously, it should be stopped at least four weeks before surgery and at least two weeks if taken by injection.

“If you take tocilizumab intravenously, it should be stopped at least four weeks before surgery. If you take tocilizumab subcutaneously (by injection or injection pen), it should be stopped at least two weeks before surgery.”

https://www.versusarthritis.org/about-arthritis/treatments/drugs/tocilizumab/

However, we agree with jamieA, and suggest speaking to your rheumatology team for a clarification for you and your situation. Hopefully this gets sorted out for you soon 😊

Best wishes,

Sharmin – Helpline Advisor