Long-Term Antibiotic Treatment in Reactive Arthritis

Pott-Júnior, Henrique; Wittenborg, A; Junge-Hülsing, G; Estreich, S.; Forster, G E

doi:10.1016/s0140-6736(88)91102-6

Cited by 34 publications

(4 citation statements)

References 2 publications

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“…Most studies on the treatment of chronic spondylarthropathies have focused on the treatment of Reiter's disease. Some uncontrolled studies favour the use of prolonged tetracycline (37) or minocycline (35) in patients with chronic Reiter's disease. In addition to its antimicrobial effect, minocycline also has immunomodulatory properties, which could contribute to the amelioration of arthritis analogous to the preliminary good results achieved in rheumatoid arthritis (5).…”

Section: Use Of Chemotherapy In Chronic Reactive Arthritismentioning

confidence: 99%

Are antibiotics of any use in reactive arthritis?

Leirisalo‐Repo

1993

Apmis

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In the pathogenesis of reactive arthritis, infection through the mucosal route and genetic susceptibility (HLA‐B27) are the most important contributing factors. With regard to non‐specific urethritis, most probably caused by Chlamydia trachomatis infection, the use of early antimicrobial therapy has been shown to be effective in preventing arthritic recurrences. When the arthritis has been initiated, short‐term conventional antimicrobial therapy seems unable to modify the course of the ongoing disease. In patients with acute reactive arthritis, a prolonged (3‐month) treatment with tetracycline shortens the duration of arthritis when triggered by Chlamydia trachomatis, while such treatment has not proved effective in enteroarthritis. In patients with chronic reactive enteroarthritis, a prolonged course of quinolones, such as ciprofloxacin, might be of benefit. Sulfasalazine, which has an effect in the acute exacerbations of ankylosing spondylitis, is probably also effective in chronic reactive arthritis. An antimicrobial effect can be one of the mechanisms by which sulfasalazine exerts its therapeutic effect. Follow‐up studies are necessary to assess the influence of antibiotic therapy on the late prognosis of patients with reactive arthritis.

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Section: Use Of Chemotherapy In Chronic Reactive Arthritismentioning

confidence: 99%

Are antibiotics of any use in reactive arthritis?

Leirisalo‐Repo

1993

Apmis

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“…Penicillin or minocycline for three months,29 or doxycycline for 3–4 months,30improved pain, stiffness, functioning, inflammation, and clinical assessment of disease activity and prevented relapse during two years of follow up.…”

Section: Discussionmentioning

confidence: 99%

Randomised, blinded, placebo controlled trial of doxycycline for chronic seronegative arthritis

Śmieja¹,

MacPherson²,

Kean³

et al. 2001

Annals of the Rheumatic Diseases

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Objective-To determine whether long term doxycycline improves symptoms in patients with chronic seronegative or reactive arthritis. Methods-A randomised, triple blind, controlled clinical trial of three months' treatment with doxycycline or placebo of patients with chronic reactive or seronegative arthritis was conducted. The primary study end points were three month pain and functional status measured by a self administered Arthritis Impact Measurement Scales version 2 (AIMS2) quality of life questionnaire. Secondary end points were pain and functional status at 6-12 months, three month rheumatologist assessed joint count, pain, and arthritis activity, and treatment eYcacy in those with previous exposure to chlamydia. Results-Of 60 patients randomly allocated to receive doxycycline or placebo, results from 37 were evaluable at three months. Groups were well balanced for major prognostic variables. Doxycycline had no detectable eVect at three months on pain change scores (mean diVerence 1.5, 95% CI −1.2 to 4.2, p=0.25) or composite functional change scores (mean diVerence 0.8, 95% CI −5.6 to 7.1, p=0.81). Furthermore, there were no diVerences in secondary study end points, and no apparent treatment eVect in patients with previous chlamydia infection. Conclusion-Three months' treatment with doxycycline did not improve pain or functional status in patients with chronic reactive or seronegative arthritis.

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“…A protocol for a Cochrane systematic review has been established to evaluate this contentious area. (Ib, A) 7,16,55,105–112,114–121 Medical synovectomy using Yttrium-90, osmic acid, Samarium-153 or Rhenium-186. All have been shown to have short-term benefit in chronic mono-articular synovitis.…”

Section: Managementmentioning

confidence: 99%