Outcomes in Reactive Arthritis

Keat, Andrew; Hamdulay, Shahir

doi:10.1016/b978-0-323-03622-1.50030-6

Cited by 2 publications

(5 citation statements)

References 56 publications

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“…Nonetheless, numerous trials of antibiotic therapy have been undertaken. 40 In spite of using a range of appropriate antibiotics over short, medium and long periods of time, the results have been disappointing, efficacy being uncertain. 41 In this respect, the result of the trial by Carter et al 42 is remarkable, particularly as it comprised patients with chronic arthritis.…”

Section: Inferences From Antimicrobial Treatment Of Reamentioning

confidence: 99%

Observations on Chlamydia trachomatis and other microbes in reactive arthritis

Taylor‐Robinson

Keat

2014

Int J STD AIDS

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There are problems in attributing causality in inflammatory arthritis. So far as C. trachomatis and sexually acquired reactive arthritis are concerned, there is much in favour of a causal relationship, although there are important caveats which need to be explored before it is possible to say unreservedly that C. trachomatis plays a causative role in reactive arthritis. For example, micro-organisms have never been cultured from synovial effusions in early disease, and only once has substantial benefit of antimicrobial treatment been reported. The claim that ocular strains of C. trachomatis are of over-riding importance in pathogenesis needs confirmation before it can be accepted. No conclusion can be made about the possibility of other small intracellular bacteria in joints having a role in causing disease. However, if it can be shown that eradication of the micro-organism, which may be difficult to prove, coincides with clinical recovery, it would go some way to recognising causality. In spite of the recognised difficulties, antibiotic studies have an important role in identifying aetiology. They need to focus on very early disease and on eradication of intra-articular bacteria. Treatment of established disease is likely to be less informative. Although a combination of antibiotics might have a future in treating established disease, diagnosing and treating non-gonococcal urethritis as soon as possible should be the aim in order to prevent the development of reactive arthritis.

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Section: Inferences From Antimicrobial Treatment Of Reamentioning

confidence: 99%

Observations on Chlamydia trachomatis and other microbes in reactive arthritis

Taylor‐Robinson

Keat

2014

Int J STD AIDS

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“…The evidence of efficacy of antimicrobial treatment of reactive arthritis has been reviewed elsewhere [7]. In both peripheral and axial SpA, therefore, there is a strong desire for more effective symptom-controlling agents and a need for drugs that truly modify disease outcome.…”

Section: Limitations Of Conventional Approaches To Treatmentmentioning

confidence: 99%

“…Studies of short-term and long-term antibiotic mono-therapy have indicated both the presence and lack of clinical efficacy [7]. Establishing or refuting a role for antibiotic treatment in reactive arthritis is hindered by the lack of a gold standard diagnostic test to identify a presumed causal microorganism(s) and to demonstrate its eradication by appropriate treatment.…”

Section: Biologic Treatment Of Spondyloarthritidesmentioning

confidence: 99%

“…In spite of evidence linking infection with the pathogenesis of both axial and peripheral SpA, notably reactive arthritis, the potential efficacy of antimicrobial therapy on the course of SpA remains uncertain. The evidence of efficacy of antimicrobial treatment of reactive arthritis has been reviewed elsewhere [ 7 ]. In both peripheral and axial SpA, therefore, there is a strong desire for more effective symptom-controlling agents and a need for drugs that truly modify disease outcome.…”

Section: Limitations Of Conventional Approaches To Treatmentmentioning

confidence: 99%

“…In spite of the concept that reactive arthritis is initiated and driven by persistent bacterial infection, evidence that this is so or that the course of the disease is influenced by antimicrobial treatment is limited and controversial. Studies of short-term and long-term antibiotic mono-therapy have indicated both the presence and lack of clinical efficacy [ 7 ]. Establishing or refuting a role for antibiotic treatment in reactive arthritis is hindered by the lack of a gold standard diagnostic test to identify a presumed causal microorganism(s) and to demonstrate its eradication by appropriate treatment.…”

Section: Biologic Treatment Of Spondyloarthritidesmentioning

confidence: 99%

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Spondyloarthritides: evolving therapies

Barr

Keat

2010

Arthritis Res Ther

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TNF blockade therapy has substantially advanced the treatment of peripheral spondyloarthritides but revolutionised the treatment of severe ankylosing spondylitis. The capacity of biologic treatment to improve dramatically symptoms and quality of life in patients with spinal disease is undoubted, although important questions remain. Notable amongst these are concerns about skeletal disease modification and the true balance between costs and effectiveness. Guidelines for the biologic treatment of ankylosing spondylitis and psoriatic arthritis have been introduced in North America and Europe with considerable consensus. However, the absence of clear criteria for the diagnosis of early disease leaves the issue of biologic treatment of ankylosing spondylitis at the pre-radiographic stage unresolved. Newer biologic agents are entering the field, although superiority over TNF blockers will be difficult to demonstrate.

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Outcomes in Reactive Arthritis

Cited by 2 publications

References 56 publications

Observations on Chlamydia trachomatis and other microbes in reactive arthritis

Observations on Chlamydia trachomatis and other microbes in reactive arthritis

Spondyloarthritides: evolving therapies

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