Immunosuppressants vs. Shorter HoldImmunosuppressant Management in Rheumatology Patients Undergoing Elective Total Shoulder Arthroplasty

Inclusion Criteria:

1. Adults aged 18 years and older at the time of informed consent;
2. Diagnosis of rheumatic disease: rheumatoid arthritis (RA), psoriatic arthritis (PA) , ankylosing spondylitis (AS), systemic lupus erythematosus (SLE), juvenile idiopathic arthritis (JIA), spondyloarthritis, polymyalgia rheumatica, giant cell arteritis, vasculitis, granulomatosis with polyangiitis, dermatomyositis, polymyositis, and inflammatory bowel disease-associated arthritis;
3. On active immunosuppression for at least 3 months prior to scheduled surgery;
4. Scheduled for elective total shoulder arthroplasty;
5. Able and willing to provide written informed consent prior to any study specific procedures.

Exclusion Criteria:

• Patients with active infections or malignancies;
• Patients undergoing shoulder arthroplasty for fracture or tumor;
• Pregnancy or breastfeeding;
• Unable to provide informed consent;
• Patients with severe SLE with marked activity - as they should be offered enrollment in the observational arm. All such patients should remain on treatment to avoid worsening of disease activity;
• Unable or without capacity to provide written informed consent prior to any study specific procedures.