Prolonged remission of chronic reactive arthritis treated with three infusions of infliximab.
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.
Wechalekar
Mihir D
MD
Department of Rheumatology, The Queen Elizabeth Hospital, Adelaide, Australia.
Rischmueller
Maureen
M
Whittle
Samuel
S
Burnet
Simon
S
Hill
Catherine L
CL
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
D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D000069285:Infliximab