REACTIVE ARTHRITIS-MANAGEMENT

SUMMARY

1. NSAIDs and systemic steroids for short-term symptomatic releif.

2. For severe or disabling disease, sulfasalazine or methotrexate is used.

3. TNF inhibitors are used rarely and only in extreme refractory cases.

4. Abx may be useful in treating the initial acute infection and may help prevent the development of ReA, but once the arthritis has begun, long-term antimicrobials do not modify disease course.

5. ReA should be at the top of your list for any patient < 50 years old who develops an acute, asymmetric large-joint arthritis in the setting of a recent GI/GU infection (within 2-4 weeks).

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].