Effect of a three month course of ciprofloxacin on the late prognosis of reactive arthritis

Finish researchers have recently investigated the value of antibiotics in the treatment of reactive arthritis (ReA). The primary objective of their investigation was to analyse the long-term outcome of patients with ReA, treated with a three-month course of ciprofloxacin or placebo.To achieve this aim, patients were recruited from a previous double blind, placebo controlled trial on the effectiveness of ciprofloxacin conducted four to seven years previously. These subjects, who had initially been diagnosed with ReA, were invited to a clinical examination. Of the 71 patients who were included in the original study, 53 agreed to visit the clinic for an examination. Twenty-six of these patients had originally received ciprofloxacin and 27 had belonged to the placebo group. Of these, 20 in the ciprofloxacin and 25 in the placebo group were HLA-B27 positive.The results identify that upon clinical examination 11/27 (41%) patients in the original placebo group had now developed chronic rheumatic disease, as compared with only 2/26 (8%) patients originally treated with ciprofloxacin (p=0.006). In addition, two patients who originally had received placebo and none in the ciprofloxacin group had developed ankylosing spondylitis. Furthermore, three patients in the original placebo group and none in the ciprofloxacin group had developed recurrent anterior uveitis.The same tendency was reported by the authors when several different measures were analysed. Of the patients with chronic spondyloarthropathy, 10 in the placebo and none in the ciprofloxacin group were HLA-B27 positive.In their conclusion the researchers comment that, "analysis 4-7 years after the initial ReA suggests that a three month course of antibiotics in the acute phase may have a beneficial effect on the long term prognosis".Reference...