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Reactive Arthritis: Treatment Challenges and Future Perspectives.
Daniel Wendling1,2, Clément Prati3,4, Mickael Chouk3
1Department of Rheumatology, CHRU de Besançon (University Teaching Hospital), Boulevard Fleming, 25030, Besançon, France. dwendling@chu-besancon.fr.
Current Rheumatology Reports
|May 28, 2020
Summary
Reactive arthritis, an infection-related synovitis, can lead to long-term disability. Early diagnosis and treatment with NSAIDs or DMARDs are crucial for managing this condition.
Area of Science:
- Rheumatology
- Immunology
- Microbiology
Background:
- Reactive arthritis is characterized by synovitis secondary to a distant infection.
- Its clinical course is variable, ranging from self-limited episodes to chronic forms with functional impairment and sequelae.
Purpose of the Study:
- To review recent findings in reactive arthritis, including etiological agents and pathophysiological mechanisms.
- To discuss current and emerging treatment strategies for reactive arthritis.
Main Methods:
- Literature review of microbiological and immunological studies.
- Analysis of clinical data on treatment outcomes for reactive arthritis.
Main Results:
- New microbiological agents have been implicated in reactive arthritis.
- Pathophysiological insights highlight the role of mucosal immunity, specific cell populations, and pro-inflammatory cytokines.
- Non-steroidal anti-inflammatory drugs (NSAIDs) are first-line treatments; synthetic and biological disease-modifying antirheumatic drugs (DMARDs) are used for refractory cases.
- Available data suggest biological DMARDs offer good efficacy and safety.
Conclusions:
- Reactive arthritis remains a significant clinical challenge.
- Prompt diagnosis based on clinical presentation and history is essential for timely and appropriate treatment initiation.
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