Source: Ophthalmology  |  Posted 8 years ago

Patients with reactive arthritis treated with lymecycline follow the same disease progression as untreated patients, according to a recent Finnish study.

Reactive arthritis is a potential consequence of gastrointestinal or genitourinary tract infection. Although acute arthritis is typically resolved within a few months, long-term joint discomfort, lower back pain, and enthesopathy is experienced by a majority of patients.

Patients with acute reactive arthritis can be treated with antimicrobial drugs. The long-term effect of antibiotic treatment on disease progression, however, is unknown.

Dr M. Leirisalo-Repo and colleagues at the Helsinki University Central Hospital, Finland, conducted a double-blind controlled study to evaluate the effects of lymecycline treatment on progression of reactive arthritis.

The study included 17 patients with reactive arthritis due to []chlamydia[], []yersinia[], or []campylobacter[]. Nine were treated with lymecycline (300 mg 3 times daily) for 3 months and 8 with placebo. Physical and clinical examinations were performed 10 years after index arthritis attack.

At follow-up, 94% of patients reported back pain and 59% reported peripheral joint symptoms. Four had sacroiliitis and 2 had radiocarpal joint erosion.

Overall, 1 patient progressed to ankylosing spondylitis and another to chronic spondyloarthropathy.

No significant differences were observed in the development of chronic arthritis, sacroiliitis, or ankylosing spondylitis between antibiotic and placebo groups.

Dr. Leirisalo-Repo concluded from the study that "long term lymecycline treatment did not change the natural history of the disease."