title: Prolonged remission of chronic reactive arthritis treated with three infusions of infliximab.
abstract: Reactive arthritis is generally self-remitting but can be chronic. Predictors of chronicity include HLA B27 positivity and triggering infections with Yersinia, Salmonella, Shigella, or Chlamydia. Nonsteroidal antiinflammatory drugs and local steroids are the mainstays, with some evidence for disease modifying antirheumatic drugs. Limited evidence suggests effectiveness of tumor necrosis factor antagonists. We report the case of reactive arthritis following a Chlamydia urinary tract infection progressing to a chronic course, treated with a short course of high dose tumor necrosis factor antagonist, followed up for over 2 years with prolonged remission, allowing discontinuation of disease modifying antirheumatic drug therapy.
authors.affiliation: Department of Rheumatology, The Queen Elizabeth Hospital, Adelaide, Australia.
authors.forename: Mihir D
authors.initials: MD
authors.lastname: Wechalekar
authors.forename: Maureen
authors.initials: M
authors.lastname: Rischmueller
authors.forename: Samuel
authors.initials: S
authors.lastname: Whittle
authors.forename: Simon
authors.initials: S
authors.lastname: Burnet
authors.forename: Catherine L
authors.initials: CL
authors.lastname: Hill
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D016918:Arthritis, Reactive / Q000188:drug therapy*; D002690:Chlamydia Infections / Q000150:complications* / Q000188:drug therapy; D002692:Chlamydia trachomatis; D005260:Female; D006801:Humans; D000069285:Infliximab; D007262:Infusions, Intravenous
chemical_list: D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D000069285:Infliximab