Evolution over thirty years of the profile of inpatients with reactive arthritis in a tertiary rheumatology unit / Evolución durante 30 años del perfil de pacientes hospitalizados con artritis reactiva en una unidad de reumatología de tercer nivel

Reactive arthritis (ReA) is sterile arthritis occurring after extra articular bacterial infection. The aim of this study was to analyze, over 30 years, clinical, biological and imaging characteristics as well as therapeutic management of new cases of ReA, comparing two periods. Methods. retrospective monocentric study, data of all the patients followed in our unit between January 1st 1984 and April 2014 with the diagnosis or ReA were analyzed (clinical and biological features, management and outcome), and compared between two periods: from January 1984 to December 1993, and from January 2004 to December 2013. Results. Sixty two patients fulfilling international diagnosis criteria were analyzed. There was no significant difference between the two periods in number of new cases, clinical presentation, biological data or outcome. Changes in therapeutic management were obvious with occurrence of anti TNF in the recent period. Conclusion. Reactive arthritis is still a current rheumatologic problem in a developed country, with a need of early and tailored rheumatologic management (AU)

Las artritis reactivas (ARe) son artritis estériles que se manifiestan después de una infección bacteriana extraarticular. El objetivo de este estudio es analizar, durante 30 años, las características clínicas, biológicas e imagenológicas, así como la gestión del tratamiento de la ARe, mediante la comparación de 2 periodos. Métodos. Estudio retrospectivo monocéntrico. Se analizaron los datos de todos los pacientes diagnosticados con ARe en nuestra unidad entre el 1 de enero de 1984 y abril de 2014 (rasgos clínicos y biológicos, gestión y resultados) y se compararon con 2 periodos: de enero de 1984 a diciembre de 1993, y de enero de 2004 a diciembre de 2013. Resultados. Se analizaron los datos de 62 pacientes que cumplieron los criterios de diagnóstico internacionales. No existió una diferencia significativa entre los 2 periodos en la cantidad de casos, presentación clínica, datos biológicos o resultados. Los cambios de la gestión del tratamiento fueron evidentes, con la aparición de anti-TNF en el periodo reciente. Conclusión. La artritis reactiva continúa siendo un problema reumatológico actual en los países desarrollados, con una necesidad de tratamiento reumatológico temprano y personalizado (AU)

Evolution over thirty years of the profile of inpatients with reactive arthritis in a tertiary rheumatology unit.

Reactive arthritis (ReA) is sterile arthritis occurring after extra articular bacterial infection. The aim of this study was to analyze, over 30 years, clinical, biological and imaging characteristics as well as therapeutic management of new cases of ReA, comparing two periods. METHODS: retrospective monocentric study, data of all the patients followed in our unit between January 1st 1984 and April 2014 with the diagnosis or ReA were analyzed (clinical and biological features, management and outcome), and compared between two periods: from January 1984 to December 1993, and from January 2004 to December 2013. RESULTS: Sixty two patients fulfilling international diagnosis criteria were analyzed. There was no significant difference between the two periods in number of new cases, clinical presentation, biological data or outcome. Changes in therapeutic management were obvious with occurrence of anti TNF in the recent period. CONCLUSION: Reactive arthritis is still a current rheumatologic problem in a developed country, with a need of early and tailored rheumatologic management.

A bicentre retrospective study of features and outcomes of patients with reactive arthritis.

OBJECTIVE: Reactive arthritis (ReA) is a sterile arthritis following an extra-articular infection, usually of the gastrointestinal or genitourinary tract. The aim of this study was to assess the incidence and the clinical and therapeutic characteristics of ReA and to compare them with those of a historical cohort. We hypothesised that improved hygiene together with prevention and treatment of sexually transmitted infections may have decreased the incidence of ReA. METHODS: All patients with ReA diagnosed in the University Hospital Centres of Lyon Sud and Besançon from January 2002 to December 2012 were included in the study retrospectively and were compared with ReA patients diagnosed from January 1986 to December 1996 in the same two hospitals. Medical records were reviewed, clinical features, treatments and outcomes were analysed and diagnoses were compared with international diagnostic criteria. RESULTS: Twenty-seven patients were included between 2002 and 2012 compared with 31 between 1986 and 1996. The overall incidence of ReA in patients hospitalised in the rheumatology department did not change, although the current evolution is more severe with development of chronic disease in the form of more frequent spondyloarthritis. While the incidence of Chlamydiae trachomatis has decreased, new microbes are now found to be involved. CONCLUSIONS: ReA still exists and its incidence has been stable over the last 30 years. However, ReA currently more often progress to spondyloarthritis. Our study also highlights the need for diagnostic criteria that accurately detect ReA.