Treatment: Reactive Arthritis

• Controlled trials have failed to demonstrate any benefit of antibiotics in reactive arthritis. Prompt antibiotic treatment of acute chlamydial urethritis may prevent subsequent reactive arthritis.
• NSAIDs (e.g., indomethacin 25-50 mg PO tid) benefit most pts.
• Intra-articular glucocorticoids.
• Sulfasalazine up to 3 g/d in divided doses may help some pts with persistent arthritis.
• Immunosuppressive agents, such as azathioprine (1-2 [mg/kg]/d) or methotrexate (7.5-15 mg/week) may be considered for debilitating disease refractory to other modalities; contraindicated in HIV disease.
• Anti-TNF agents can be considered in severe chronic cases.
• Uveitis may require therapy with ocular or systemic glucocorticoids.