TABLE 12.

Evidence of the role of long-term antibacterial treatment in ReA

ReferenceStudy designNo. of patients and diagnosisInterventionResults
150 Open (no control group)10 C. trachomatis ReA3-mo treatment with minocyclineImprovement in clinical parameters (pain, morning stiffness, Schobert, etc.)
113 Double-blind, randomized40 ReA (21 Chlamydia ReA, 17 entero-ReA)3 mo, 21 patients given lymecycline and 19 patients given placeboFavourable effect in chlamydia-induced ReA but not in other groups
108 Follow-up17 ReA (9 lymecycline group, 8 placebo group)Follow-up 10 yr after the index attack of ReATreatment strategy at the acute index attack had no major effect on the outcome
222 Double-blind, randomized32 Chamydial ReA2 wk vs 4 mo of doxycyclineLong-term treatment is not superior to short-term treatment
181 Double-blind, randomized116 ReA (104 uro-ReA)Ciprofloxacin vs placebo for 3 moNo difference in outcome between ciprofloxacin and placebo treatment
203 Double-blind, randomized36 patients chronic ReA (32 entero ReA, 4 Chlamydial ReA)Ciprofloxacin vs placebo for 3 moNo definite advantage of ciprofloxacin
229 Double blind, randomized71 acute ReA (60 entero-ReA, 11 uro-ReA)Ciprofloxacin vs placebo for 3 moNo differences in efficacy variables at 12 wk
230 Follow-up53 ReA (mostly entero-ReA) (26 ciprofloxacin group, 27 placebo)Follow-up 4-7 yr after the initial ReATreatment in acute phase may prevent the development of chronic rheumatic diseases (especially in HLA-B27)