Reactive Arthritis: Developments and Challenges in Diagnosis and Treatment
Current Rheumatology Reports, 08/03/2012
Morris D et al. – The studies in treatment modalities require validation on larger samples but do provide some encouraging preliminary findings from which to develop new therapeutic approaches.
- Reactive arthritis (ReA) has traditionally been described as a nonseptic arthritis occurring in the joint following an extra-articular bacterial infection.
- This concept became clinically associated with antecedent infections of either the gastrointestinal or genitourinary tract.
- Yet this operational definition of ReA has led to diagnostic uncertainty in different clinical settings.
- There are several scenarios in which the ReA has been complex.
- One is in the SAPHO syndrome, which shares many features with ReA.
- Another is the development of arthritis after infection with atypical organisms such as Clostridium difficile and Giardia lamblia.
- Treatment of ReA remains an area of ongoing investigation.
- There has been a randomized controlled trial of combination antibiotics in Chlamydia-induced ReA, which reported a positive result.
- There are several uncontrolled reports of anti-TNF agents being used successfully in refractory ReA.