The use of long-term antibiotics to treat ReA remains controversial. A randomized trial suggests that a six-month course of antibiotic therapy may be effective for Chamydial ReA, but this has not been observed for other causative organisms.16 A recent meta-analysis of antibiotic treatment for ReA failed to show any benefit, although the included trials were very heterogeneous.17 Prevention of ReA may be possible by the prompt recognition and treatment of Chamydial infections, but this has not been shown for other causes of ReA.21
The recognition of the autoinflammatory nature of this disease and the role of the innate immune system in its pathogenesis may help guide future treatment.
Dr. Hausmann is a pediatric and adult rheumatology fellow at Boston Children’s Hospital and Beth Israel Medical Center.
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