What are the treatment options for human leukocyte antigen (HLA) B27–associated reactive arthritis?

Updated: Apr 09, 2021
  • Author: Huy D Nguyen, MD, MBA; Chief Editor: Andrew A Dahl, MD, FACS  more...
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Answer

Answer

Treatment is empirical and aimed at relieving symptoms. Patient education, reassurance, and physical therapy are of paramount importance. Acute arthritis is treated with analgesics and nonsteroidal anti-inflammatory drugs, such as indomethacin. Whether antibiotics help in reactive arthritis is unclear; however, it is known that treatment of acute chlamydial urethritis may prevent subsequent reactive arthritis.

Systemic corticosteroids should be avoided because they can aggravate the cutaneous manifestations of the disease, but local administration can help persistent monoarthritis, fasciitis, and tendonitis. In chronic destructive arthritis, cytotoxic drugs, such as methotrexate or azathioprine, may be beneficial. Uveitis usually is treated with topical steroids. Periocular steroids, systemic corticosteroids, and steroid-sparing immunomodulatory therapies can be used depending on the severity and response to treatment. [31]


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