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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
PubMed
Abstract

Insights

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.
Keywords:
Anti-TNF agentsBiodrugsInterleukin-17Interleukin-23Reactive arthritisSpondyloarthritisTreatment

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