Reaktywne zapalenie stawów – Rokowania, prognozy i postęp choroby

Reaktywne zapalenie stawów
Rokowania, prognozy i postęp choroby

Reaktywne zapalenie stawów (ReA) cechuje się zmiennym przebiegiem klinicznym, zwykle samoograniczającym się z ustąpieniem objawów w ciągu 3-12 miesięcy, przy czym około 50% pacjentów doświadcza objawów krótszych niż 6 miesięcy. Przewlekły przebieg, definiowany jako utrzymujący się powyżej 6 miesięcy, występuje u 30-63% chorych, a u około 25% objawy trwają ponad rok, co może prowadzić do rozwoju przewlekłej spondyloartropatii. Czynniki prognostyczne cięższego i przewlekłego przebiegu obejmują obecność antygenu HLA-B27 (występującego u 30-80% pacjentów), typ infekcji (szczególnie Chlamydia, Yersinia, Salmonella, Shigella), dodatni wywiad rodzinny w kierunku spondyloartropatii, zajęcie stawu biodrowego, podwyższone OB powyżej 30 mm/h, brak odpowiedzi na NLPZ oraz współistniejące przewlekłe zapalenie jelit. Nawrót choroby występuje u 15-50% pacjentów, zwłaszcza u nosicieli HLA-B27, a około 15-30% rozwija długotrwałe zapalenie stawów, zapalenie przyczepów ścięgnistych lub zapalenie kręgosłupa, z możliwością progresji do zesztywniającego zapalenia stawów kręgosłupa lub radiologicznego zapalenia stawów krzyżowo-biodrowych.

Reaktywne zapalenie stawów – Rokowanie (przewidywanie wyniku)

Przewlekły przebieg choroby
Czynniki prognostyczne
Nawroty choroby
Potencjalne powikłania długoterminowe
Potencjalne biomarkery prognostyczne
Podsumowanie rokowania
Kolejne rozdziały

Reaktywne zapalenie stawów – Rokowanie (przewidywanie wyniku)

Reaktywne zapalenie stawów (ReA) charakteryzuje się zmiennym przebiegiem klinicznym, co wpływa na możliwość przewidywania jego rozwoju. Typowo jest to schorzenie samoograniczające się, z ustąpieniem objawów w ciągu 3-12 miesięcy, nawet u pacjentów, którzy początkowo doświadczają znacznej niesprawności.¹² Około 50% pacjentów doświadcza objawów trwających 6 miesięcy lub krócej.³ Śmiertelność w przebiegu ReA jest rzadka i zwykle związana z działaniami niepożądanymi stosowanego leczenia.⁴

Przewlekły przebieg choroby

Objawy utrzymujące się powyżej 6 miesięcy wskazują na przewlekły element choroby.⁵ Około 30-63% pacjentów rozwija przewlekłe reaktywne zapalenie stawów trwające ponad 6 miesięcy i wymaga ponownego leczenia.⁶ Około 25% pacjentów doświadcza objawów trwających ponad rok, co określa się jako przewlekłe reaktywne zapalenie stawów lub przewlekłą spondyloartropatię.⁷ Nawet w przypadkach przewlekłych, choroba zazwyczaj ustępuje samoistnie, choć może wymagać długotrwałego leczenia lub monitorowania przez lekarzy.⁸

Czynniki prognostyczne

Zidentyfikowano kilka czynników, które mogą wpływać na rokowanie w reaktywnym zapaleniu stawów:

Obecność HLA-B27 – częstość występowania HLA-B27 wśród pacjentów z ReA waha się od 30-80%. Nosiciele HLA-B27 mają wyższe ryzyko nawrotu choroby i są bardziej narażeni na ciężki przebieg choroby, z częstym zajęciem kręgosłupa, cechami pozastawowymi i przewlekłym przebiegiem zapalenia stawów.⁹¹⁰¹¹¹²
Typ wywołującej infekcji – przypadki pozajelitowe mają lepsze rokowanie niż przypadki pozaweneryczne. Zakażenia wywołane przez Yersinia, Salmonella, Shigella lub Chlamydia mogą przewidywać dłuższy i cięższy przebieg.¹³¹⁴
Wywiad rodzinny spondyloartropatii – pozytywny wywiad rodzinny w kierunku spondyloartropatii lub zesztywniającego zapalenia stawów kręgosłupa jest związany z gorszym rokowaniem.¹⁵¹⁶
Zajęcie stawu biodrowego – obecność zajęcia stawu biodrowego wskazuje na ciężki przebieg lub przewlekłość w ReA.¹⁷¹⁸
Podwyższone OB – wartość OB wyższa niż 30 mm/h zwykle zapowiada ciężki przebieg lub przewlekłość w ReA.¹⁹²⁰
Brak odpowiedzi na NLPZ – brak odpowiedzi na niesteroidowe leki przeciwzapalne prawdopodobnie zapowiada ciężki przebieg lub przewlekłość w ReA.²¹²²
Przewlekłe zapalenie jelit – utrzymujące się zapalenie jelita wydaje się odgrywać istotną rolę w określaniu przebiegu i rokowania reaktywnego zapalenia stawów.²³²⁴

Nawroty choroby

ReA charakteryzuje się wysoką tendencją do nawrotów, występujących w 15-50% przypadków, szczególnie u osób z pozytywnym wynikiem HLA-B27.²⁵²⁶ Nowe zakażenie lub inny czynnik stresowy może spowodować reaktywację choroby.²⁷ Nawroty mogą występować u nawet połowy pacjentów w ciągu lat.²⁸

Potencjalne powikłania długoterminowe

Około 15-30% pacjentów z ReA rozwija długotrwałe, czasami destrukcyjne zapalenie stawów, zapalenie przyczepów ścięgnistych lub zapalenie kręgosłupa.²⁹³⁰ Zapalenie stawów krzyżowo-biodrowych jest najczęstszym przewlekłym zajęciem stawów.³¹ Niewielki odsetek pacjentów z reaktywnym zapaleniem stawów może rozwinąć zesztywniające zapalenie stawów kręgosłupa lub radiologiczne zapalenie stawów krzyżowo-biodrowych.³²

W małym odsetku pacjentów, zespół Reitera (reaktywne zapalenie stawów) wydaje się wyzwalać poważniejszą i długotrwałą formę spondyloartropatii. Rozwijają oni długoterminowe zapalenie stawów, które może powodować realne uszkodzenia w miarę upływu czasu.³³ Nie jest jasne, czy jest to przewlekłe reaktywne zapalenie stawów, czy też w tym przypadku rozwija się inna choroba. Jedna choroba autoimmunologiczna może wyzwolić inną, a wiele osób ma więcej niż jedną.³⁴

Rzadko stan ten może prowadzić do nieprawidłowego rytmu serca lub problemów z zastawką aortalną serca.³⁵

Potencjalne biomarkery prognostyczne

Badania naukowe zidentyfikowały potencjalne sygnatury molekularne, które mogą służyć jako markery prognostyczne lub teranostyczne dla ReA, szczególnie gdy współwystępuje z chorobą zapalną jelit (IBD):

Na(+)/H(+) antyporter (NHAA) i Kynureninaza (KYNU) – zidentyfikowane jako wczesne i istotne cele interakcji gospodarz-mikrob dla ReA współwystępującego z IBD³⁶
Inne kluczowe geny, białka i szlaki interakcji gospodarz-mikrob:
- Deaminaza adenozynowa (ADA)³⁷
- Dysmutaza ponadtlenkowa 2 (SOD2)³⁸
- Katalaza (CAT)³⁹
- Enzym konwertujący angiotensynę I (ACE)⁴⁰
- Metabolizm węgla (biosynteza folianów)⁴¹
- Metotreksat – jako potencjalny marker teranostyczny⁴²

Zarządzanie rzadkim, złożonym, nakładającym się autoimmunologicznym zaburzeniem, jakim jest ReA, w celu zapobiegania jego progresji i nawrotom, zależy od szczegółowych badań asocjacyjnych mikrobiomów z genetyką gospodarza, strukturyzujących trendy immunogenne.⁴³ Potrzebne są przyszłe badania na większej kohorcie pacjentów z ReA z powodu IBD, aby uzyskać zwalidowane wyniki sieci predykcyjnej.⁴⁴

Podsumowanie rokowania

Reaktywne zapalenie stawów ma ogólnie dobre rokowanie i samoograniczający się przebieg z pełnym wyzdrowieniem w ciągu trzech do pięciu miesięcy.⁴⁵ Przebieg reaktywnego zapalenia stawów jest zmienny, ale u większości osób zaburzenie jest samoograniczające się, z ustąpieniem objawów w ciągu 6-18 miesięcy.⁴⁶

Czynniki takie jak obecność HLA-B27, specyficzne infekcje (szczególnie wywołane przez Chlamydia), wywiad rodzinny spondyloartropatii, zajęcie stawu biodrowego, podwyższone OB, brak odpowiedzi na NLPZ oraz przewlekłe zapalenie jelit mogą wpływać na ciężkość i progresję choroby, prowadząc do dłuższego, przewlekłego przebiegu i potencjalnie do rozwoju innych schorzeń, takich jak zesztywniające zapalenie stawów kręgosłupa czy radiologiczne zapalenie stawów krzyżowo-biodrowych.⁴⁷⁴⁸⁴⁹

Kolejne rozdziały

Zapraszamy do dalszego czytania naszego leksykonu.

Wybierz kolejny rozdział z menu poniżej, aby otworzyć nową podstronę kompedium wiedzy i uzyskać szczegółowe informację o leku, substancji lub chorobie.

Materiały źródłowe

#1 Reactive Arthritis – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK499831/
Reactive arthritis usually has a self-limited course, and the symptoms resolve within 3 to 5 months. […] Symptoms lasting beyond 6 months indicate a chronic element of the disease. Sacroiliitis is the most common chronic joint involvement. Patients who are HLA-B27 positive have a higher risk of recurrence of ReA. 15-30% of patients with ReA can develop long-term arthritis or other joint abnormalities. The presence of hip involvement, unresponsiveness to NSAIDs, and ESR greater than 30 portend a worse outcome. […] The progression of reactive arthritis is variable, but in most people, the disorder is self-limited, with the resolution of the symptoms occurring by 6 to 18 months. Mortality is very rare today and is usually due to the treatments. In general, causes related to sexually transmitted infections have a worse outcome than those caused by gastrointestinal infections. Despite a cure, recurrences occur in 25 to 50% of cases, especially those who are HLA-B27 positive. Reactivation may signal a new infection or stress. About 20% of patients have a long-term disease that results in enthesitis and destructive arthritis. Elevation of ESR, lack of response to NSAIDs, and hip joint involvement usually indicate poor outcomes.
#2 Reactive Arthritis: Practice Essentials, Background, Pathophysiology
https://emedicine.medscape.com/article/331347-overview
ReA has a variable natural history but typically follows a self-limited course, with resolution of symptoms by 3-12 months, even in patients who are acutely incapacitated. A fatal outcome is seldom reported, but death can occur, and it is usually related to the adverse effects of treatment. Postdysenteric cases are associated with a better prognosis than postvenereal cases. The presence of HLA-B27 may predict a more prolonged course and severe outcome, as may infections triggered by Yersinia, Salmonella, Shigella, or Chlamydia. […] ReA has a high tendency to recur (15-50% of cases), particularly in individuals who are HLA-B27 positive. A new infection or other stress factor could cause reactivation of the disease. […] Approximately 15-30% of patients with ReA develop a long-term, sometimes destructive, arthritis or enthesitis or spondylitis. A 1994 study analyzed 7 factors as predictors of long-term outcome in spondyloarthropathies. The number of patients with ReA in this study was low, and a valid subgroup analysis was impossible. The presence of hip-joint involvement, an ESR higher than 30, and unresponsiveness to nonsteroidal anti-inflammatory drugs (NSAIDs) probably portend a severe outcome or chronicity in ReA.
#3 Reactive Arthritis Survival Guide
https://www.arthritis-health.com/types/reactive-arthritis/reactive-arthritis-survival-guide
Reactive arthritis usually goes away. Most people who get reactive arthritis return to normal in less than a yearâin fact, 50% of people experience symptoms for 6 months or less. About 25% of people have symptoms that last beyond one year. These people are said to have chronic reactive arthritis or chronic spondyloarthritis, and they may require long-term treatment. […] These cases may require medical care or may just warrant monitoring by doctors. Either way, these cases usually resolve on their own.
#4 Reactive Arthritis: Practice Essentials, Background, Pathophysiology
https://emedicine.medscape.com/article/331347-overview
ReA has a variable natural history but typically follows a self-limited course, with resolution of symptoms by 3-12 months, even in patients who are acutely incapacitated. A fatal outcome is seldom reported, but death can occur, and it is usually related to the adverse effects of treatment. Postdysenteric cases are associated with a better prognosis than postvenereal cases. The presence of HLA-B27 may predict a more prolonged course and severe outcome, as may infections triggered by Yersinia, Salmonella, Shigella, or Chlamydia. […] ReA has a high tendency to recur (15-50% of cases), particularly in individuals who are HLA-B27 positive. A new infection or other stress factor could cause reactivation of the disease. […] Approximately 15-30% of patients with ReA develop a long-term, sometimes destructive, arthritis or enthesitis or spondylitis. A 1994 study analyzed 7 factors as predictors of long-term outcome in spondyloarthropathies. The number of patients with ReA in this study was low, and a valid subgroup analysis was impossible. The presence of hip-joint involvement, an ESR higher than 30, and unresponsiveness to nonsteroidal anti-inflammatory drugs (NSAIDs) probably portend a severe outcome or chronicity in ReA.
#5 Reactive Arthritis – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK499831/
Reactive arthritis usually has a self-limited course, and the symptoms resolve within 3 to 5 months. […] Symptoms lasting beyond 6 months indicate a chronic element of the disease. Sacroiliitis is the most common chronic joint involvement. Patients who are HLA-B27 positive have a higher risk of recurrence of ReA. 15-30% of patients with ReA can develop long-term arthritis or other joint abnormalities. The presence of hip involvement, unresponsiveness to NSAIDs, and ESR greater than 30 portend a worse outcome. […] The progression of reactive arthritis is variable, but in most people, the disorder is self-limited, with the resolution of the symptoms occurring by 6 to 18 months. Mortality is very rare today and is usually due to the treatments. In general, causes related to sexually transmitted infections have a worse outcome than those caused by gastrointestinal infections. Despite a cure, recurrences occur in 25 to 50% of cases, especially those who are HLA-B27 positive. Reactivation may signal a new infection or stress. About 20% of patients have a long-term disease that results in enthesitis and destructive arthritis. Elevation of ESR, lack of response to NSAIDs, and hip joint involvement usually indicate poor outcomes.
#6 Reactive Arthritis: Update
https://pmc.ncbi.nlm.nih.gov/articles/PMC7519381/
Generally, the course of ReA is highly variable, whether it is disease duration, frequency, or severity of relapses. As suggested, most patients have completed remission within 612 months. However, 30 to 63% of patients develop chronic ReA remaining more than 6 months and require retreatment. Some of these patients may develop signs and symptoms of AS or inflammatory bowel disease. […] Regarding the predictive factors of worse prognosis of ReA, HLA-B27 positivity, Chlamydia-induced infection, spondyloarthropathy family history, and chronic bowel inflammation were the factors that contribute the most to severity and progression of the disease.
#7 Reactive Arthritis Survival Guide
https://www.arthritis-health.com/types/reactive-arthritis/reactive-arthritis-survival-guide
Reactive arthritis usually goes away. Most people who get reactive arthritis return to normal in less than a yearâin fact, 50% of people experience symptoms for 6 months or less. About 25% of people have symptoms that last beyond one year. These people are said to have chronic reactive arthritis or chronic spondyloarthritis, and they may require long-term treatment. […] These cases may require medical care or may just warrant monitoring by doctors. Either way, these cases usually resolve on their own.
#8 Reactive Arthritis Survival Guide
https://www.arthritis-health.com/types/reactive-arthritis/reactive-arthritis-survival-guide
Reactive arthritis usually goes away. Most people who get reactive arthritis return to normal in less than a yearâin fact, 50% of people experience symptoms for 6 months or less. About 25% of people have symptoms that last beyond one year. These people are said to have chronic reactive arthritis or chronic spondyloarthritis, and they may require long-term treatment. […] These cases may require medical care or may just warrant monitoring by doctors. Either way, these cases usually resolve on their own.
#9 Reactive Arthritis – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK499831/
Reactive arthritis usually has a self-limited course, and the symptoms resolve within 3 to 5 months. […] Symptoms lasting beyond 6 months indicate a chronic element of the disease. Sacroiliitis is the most common chronic joint involvement. Patients who are HLA-B27 positive have a higher risk of recurrence of ReA. 15-30% of patients with ReA can develop long-term arthritis or other joint abnormalities. The presence of hip involvement, unresponsiveness to NSAIDs, and ESR greater than 30 portend a worse outcome. […] The progression of reactive arthritis is variable, but in most people, the disorder is self-limited, with the resolution of the symptoms occurring by 6 to 18 months. Mortality is very rare today and is usually due to the treatments. In general, causes related to sexually transmitted infections have a worse outcome than those caused by gastrointestinal infections. Despite a cure, recurrences occur in 25 to 50% of cases, especially those who are HLA-B27 positive. Reactivation may signal a new infection or stress. About 20% of patients have a long-term disease that results in enthesitis and destructive arthritis. Elevation of ESR, lack of response to NSAIDs, and hip joint involvement usually indicate poor outcomes.
#10 Reactive Arthritis: Update
https://pmc.ncbi.nlm.nih.gov/articles/PMC7519381/
Generally, the course of ReA is highly variable, whether it is disease duration, frequency, or severity of relapses. As suggested, most patients have completed remission within 612 months. However, 30 to 63% of patients develop chronic ReA remaining more than 6 months and require retreatment. Some of these patients may develop signs and symptoms of AS or inflammatory bowel disease. […] Regarding the predictive factors of worse prognosis of ReA, HLA-B27 positivity, Chlamydia-induced infection, spondyloarthropathy family history, and chronic bowel inflammation were the factors that contribute the most to severity and progression of the disease.
#11 A Review of Reactive Arthritis
https://www.hcplive.com/view/review-reactive-arthritis
Reactive arthritis carries a good prognosis and a self-limiting course with full recovery in three to five months. […] A smaller portion of reactive arthritis patients will develop a chronic course with symptoms for more than six months. […] A small portion of reactive arthritis patients will go on to develop ankylosing spondylitis or radiological sacroiliitis. […] Poor prognostic signs include specific infections, HLA-B27 positivity, positive family history for spondyloarthritis or ankylosing spondylitis, and the presence of chronic gut inflammation. […] Data suggest that the prognosis is better for enteroarthritis than Chlamydia-induced reactive arthritis. […] The frequency of HLA-B27 among reactive arthritis patients ranges from 30-80 percent, and HLA-B27 carriers are more likely affected by severe disease, with frequent spine involvement, extra-articular features and a chronic course of arthritis. […] Persistent gut inflammation appears to play a significant role in determining the course and prognosis of reactive arthritis.
#12 Signs of reactive arthritis | Ada
https://ada.com/conditions/reactive-arthritis/
The course of disease can differ from person to person. In about half of all people with ReA, the symptoms will resolve within six months. However, in some people, the condition may persist and become chronic. […] For people who have the HLA-B27 gene, recurrence may occur.
#13 Reactive Arthritis: Practice Essentials, Background, Pathophysiology
https://emedicine.medscape.com/article/331347-overview
ReA has a variable natural history but typically follows a self-limited course, with resolution of symptoms by 3-12 months, even in patients who are acutely incapacitated. A fatal outcome is seldom reported, but death can occur, and it is usually related to the adverse effects of treatment. Postdysenteric cases are associated with a better prognosis than postvenereal cases. The presence of HLA-B27 may predict a more prolonged course and severe outcome, as may infections triggered by Yersinia, Salmonella, Shigella, or Chlamydia. […] ReA has a high tendency to recur (15-50% of cases), particularly in individuals who are HLA-B27 positive. A new infection or other stress factor could cause reactivation of the disease. […] Approximately 15-30% of patients with ReA develop a long-term, sometimes destructive, arthritis or enthesitis or spondylitis. A 1994 study analyzed 7 factors as predictors of long-term outcome in spondyloarthropathies. The number of patients with ReA in this study was low, and a valid subgroup analysis was impossible. The presence of hip-joint involvement, an ESR higher than 30, and unresponsiveness to nonsteroidal anti-inflammatory drugs (NSAIDs) probably portend a severe outcome or chronicity in ReA.
#14 A Review of Reactive Arthritis
https://www.hcplive.com/view/review-reactive-arthritis
Reactive arthritis carries a good prognosis and a self-limiting course with full recovery in three to five months. […] A smaller portion of reactive arthritis patients will develop a chronic course with symptoms for more than six months. […] A small portion of reactive arthritis patients will go on to develop ankylosing spondylitis or radiological sacroiliitis. […] Poor prognostic signs include specific infections, HLA-B27 positivity, positive family history for spondyloarthritis or ankylosing spondylitis, and the presence of chronic gut inflammation. […] Data suggest that the prognosis is better for enteroarthritis than Chlamydia-induced reactive arthritis. […] The frequency of HLA-B27 among reactive arthritis patients ranges from 30-80 percent, and HLA-B27 carriers are more likely affected by severe disease, with frequent spine involvement, extra-articular features and a chronic course of arthritis. […] Persistent gut inflammation appears to play a significant role in determining the course and prognosis of reactive arthritis.
#15 Reactive Arthritis: Update
https://pmc.ncbi.nlm.nih.gov/articles/PMC7519381/
Generally, the course of ReA is highly variable, whether it is disease duration, frequency, or severity of relapses. As suggested, most patients have completed remission within 612 months. However, 30 to 63% of patients develop chronic ReA remaining more than 6 months and require retreatment. Some of these patients may develop signs and symptoms of AS or inflammatory bowel disease. […] Regarding the predictive factors of worse prognosis of ReA, HLA-B27 positivity, Chlamydia-induced infection, spondyloarthropathy family history, and chronic bowel inflammation were the factors that contribute the most to severity and progression of the disease.
#16 A Review of Reactive Arthritis
https://www.hcplive.com/view/review-reactive-arthritis
Reactive arthritis carries a good prognosis and a self-limiting course with full recovery in three to five months. […] A smaller portion of reactive arthritis patients will develop a chronic course with symptoms for more than six months. […] A small portion of reactive arthritis patients will go on to develop ankylosing spondylitis or radiological sacroiliitis. […] Poor prognostic signs include specific infections, HLA-B27 positivity, positive family history for spondyloarthritis or ankylosing spondylitis, and the presence of chronic gut inflammation. […] Data suggest that the prognosis is better for enteroarthritis than Chlamydia-induced reactive arthritis. […] The frequency of HLA-B27 among reactive arthritis patients ranges from 30-80 percent, and HLA-B27 carriers are more likely affected by severe disease, with frequent spine involvement, extra-articular features and a chronic course of arthritis. […] Persistent gut inflammation appears to play a significant role in determining the course and prognosis of reactive arthritis.
#17 Reactive Arthritis – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK499831/
Reactive arthritis usually has a self-limited course, and the symptoms resolve within 3 to 5 months. […] Symptoms lasting beyond 6 months indicate a chronic element of the disease. Sacroiliitis is the most common chronic joint involvement. Patients who are HLA-B27 positive have a higher risk of recurrence of ReA. 15-30% of patients with ReA can develop long-term arthritis or other joint abnormalities. The presence of hip involvement, unresponsiveness to NSAIDs, and ESR greater than 30 portend a worse outcome. […] The progression of reactive arthritis is variable, but in most people, the disorder is self-limited, with the resolution of the symptoms occurring by 6 to 18 months. Mortality is very rare today and is usually due to the treatments. In general, causes related to sexually transmitted infections have a worse outcome than those caused by gastrointestinal infections. Despite a cure, recurrences occur in 25 to 50% of cases, especially those who are HLA-B27 positive. Reactivation may signal a new infection or stress. About 20% of patients have a long-term disease that results in enthesitis and destructive arthritis. Elevation of ESR, lack of response to NSAIDs, and hip joint involvement usually indicate poor outcomes.
#18 Reactive Arthritis: Practice Essentials, Background, Pathophysiology
https://emedicine.medscape.com/article/331347-overview
ReA has a variable natural history but typically follows a self-limited course, with resolution of symptoms by 3-12 months, even in patients who are acutely incapacitated. A fatal outcome is seldom reported, but death can occur, and it is usually related to the adverse effects of treatment. Postdysenteric cases are associated with a better prognosis than postvenereal cases. The presence of HLA-B27 may predict a more prolonged course and severe outcome, as may infections triggered by Yersinia, Salmonella, Shigella, or Chlamydia. […] ReA has a high tendency to recur (15-50% of cases), particularly in individuals who are HLA-B27 positive. A new infection or other stress factor could cause reactivation of the disease. […] Approximately 15-30% of patients with ReA develop a long-term, sometimes destructive, arthritis or enthesitis or spondylitis. A 1994 study analyzed 7 factors as predictors of long-term outcome in spondyloarthropathies. The number of patients with ReA in this study was low, and a valid subgroup analysis was impossible. The presence of hip-joint involvement, an ESR higher than 30, and unresponsiveness to nonsteroidal anti-inflammatory drugs (NSAIDs) probably portend a severe outcome or chronicity in ReA.
#19 Reactive Arthritis – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK499831/
Reactive arthritis usually has a self-limited course, and the symptoms resolve within 3 to 5 months. […] Symptoms lasting beyond 6 months indicate a chronic element of the disease. Sacroiliitis is the most common chronic joint involvement. Patients who are HLA-B27 positive have a higher risk of recurrence of ReA. 15-30% of patients with ReA can develop long-term arthritis or other joint abnormalities. The presence of hip involvement, unresponsiveness to NSAIDs, and ESR greater than 30 portend a worse outcome. […] The progression of reactive arthritis is variable, but in most people, the disorder is self-limited, with the resolution of the symptoms occurring by 6 to 18 months. Mortality is very rare today and is usually due to the treatments. In general, causes related to sexually transmitted infections have a worse outcome than those caused by gastrointestinal infections. Despite a cure, recurrences occur in 25 to 50% of cases, especially those who are HLA-B27 positive. Reactivation may signal a new infection or stress. About 20% of patients have a long-term disease that results in enthesitis and destructive arthritis. Elevation of ESR, lack of response to NSAIDs, and hip joint involvement usually indicate poor outcomes.
#20 Reactive Arthritis: Practice Essentials, Background, Pathophysiology
https://emedicine.medscape.com/article/331347-overview
ReA has a variable natural history but typically follows a self-limited course, with resolution of symptoms by 3-12 months, even in patients who are acutely incapacitated. A fatal outcome is seldom reported, but death can occur, and it is usually related to the adverse effects of treatment. Postdysenteric cases are associated with a better prognosis than postvenereal cases. The presence of HLA-B27 may predict a more prolonged course and severe outcome, as may infections triggered by Yersinia, Salmonella, Shigella, or Chlamydia. […] ReA has a high tendency to recur (15-50% of cases), particularly in individuals who are HLA-B27 positive. A new infection or other stress factor could cause reactivation of the disease. […] Approximately 15-30% of patients with ReA develop a long-term, sometimes destructive, arthritis or enthesitis or spondylitis. A 1994 study analyzed 7 factors as predictors of long-term outcome in spondyloarthropathies. The number of patients with ReA in this study was low, and a valid subgroup analysis was impossible. The presence of hip-joint involvement, an ESR higher than 30, and unresponsiveness to nonsteroidal anti-inflammatory drugs (NSAIDs) probably portend a severe outcome or chronicity in ReA.
#21 Reactive Arthritis – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK499831/
Reactive arthritis usually has a self-limited course, and the symptoms resolve within 3 to 5 months. […] Symptoms lasting beyond 6 months indicate a chronic element of the disease. Sacroiliitis is the most common chronic joint involvement. Patients who are HLA-B27 positive have a higher risk of recurrence of ReA. 15-30% of patients with ReA can develop long-term arthritis or other joint abnormalities. The presence of hip involvement, unresponsiveness to NSAIDs, and ESR greater than 30 portend a worse outcome. […] The progression of reactive arthritis is variable, but in most people, the disorder is self-limited, with the resolution of the symptoms occurring by 6 to 18 months. Mortality is very rare today and is usually due to the treatments. In general, causes related to sexually transmitted infections have a worse outcome than those caused by gastrointestinal infections. Despite a cure, recurrences occur in 25 to 50% of cases, especially those who are HLA-B27 positive. Reactivation may signal a new infection or stress. About 20% of patients have a long-term disease that results in enthesitis and destructive arthritis. Elevation of ESR, lack of response to NSAIDs, and hip joint involvement usually indicate poor outcomes.
#22 Reactive Arthritis: Practice Essentials, Background, Pathophysiology
https://emedicine.medscape.com/article/331347-overview
ReA has a variable natural history but typically follows a self-limited course, with resolution of symptoms by 3-12 months, even in patients who are acutely incapacitated. A fatal outcome is seldom reported, but death can occur, and it is usually related to the adverse effects of treatment. Postdysenteric cases are associated with a better prognosis than postvenereal cases. The presence of HLA-B27 may predict a more prolonged course and severe outcome, as may infections triggered by Yersinia, Salmonella, Shigella, or Chlamydia. […] ReA has a high tendency to recur (15-50% of cases), particularly in individuals who are HLA-B27 positive. A new infection or other stress factor could cause reactivation of the disease. […] Approximately 15-30% of patients with ReA develop a long-term, sometimes destructive, arthritis or enthesitis or spondylitis. A 1994 study analyzed 7 factors as predictors of long-term outcome in spondyloarthropathies. The number of patients with ReA in this study was low, and a valid subgroup analysis was impossible. The presence of hip-joint involvement, an ESR higher than 30, and unresponsiveness to nonsteroidal anti-inflammatory drugs (NSAIDs) probably portend a severe outcome or chronicity in ReA.
#23 Reactive Arthritis: Update
https://pmc.ncbi.nlm.nih.gov/articles/PMC7519381/
Generally, the course of ReA is highly variable, whether it is disease duration, frequency, or severity of relapses. As suggested, most patients have completed remission within 612 months. However, 30 to 63% of patients develop chronic ReA remaining more than 6 months and require retreatment. Some of these patients may develop signs and symptoms of AS or inflammatory bowel disease. […] Regarding the predictive factors of worse prognosis of ReA, HLA-B27 positivity, Chlamydia-induced infection, spondyloarthropathy family history, and chronic bowel inflammation were the factors that contribute the most to severity and progression of the disease.
#24 A Review of Reactive Arthritis
https://www.hcplive.com/view/review-reactive-arthritis
Reactive arthritis carries a good prognosis and a self-limiting course with full recovery in three to five months. […] A smaller portion of reactive arthritis patients will develop a chronic course with symptoms for more than six months. […] A small portion of reactive arthritis patients will go on to develop ankylosing spondylitis or radiological sacroiliitis. […] Poor prognostic signs include specific infections, HLA-B27 positivity, positive family history for spondyloarthritis or ankylosing spondylitis, and the presence of chronic gut inflammation. […] Data suggest that the prognosis is better for enteroarthritis than Chlamydia-induced reactive arthritis. […] The frequency of HLA-B27 among reactive arthritis patients ranges from 30-80 percent, and HLA-B27 carriers are more likely affected by severe disease, with frequent spine involvement, extra-articular features and a chronic course of arthritis. […] Persistent gut inflammation appears to play a significant role in determining the course and prognosis of reactive arthritis.
#25 Reactive Arthritis – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK499831/
Reactive arthritis usually has a self-limited course, and the symptoms resolve within 3 to 5 months. […] Symptoms lasting beyond 6 months indicate a chronic element of the disease. Sacroiliitis is the most common chronic joint involvement. Patients who are HLA-B27 positive have a higher risk of recurrence of ReA. 15-30% of patients with ReA can develop long-term arthritis or other joint abnormalities. The presence of hip involvement, unresponsiveness to NSAIDs, and ESR greater than 30 portend a worse outcome. […] The progression of reactive arthritis is variable, but in most people, the disorder is self-limited, with the resolution of the symptoms occurring by 6 to 18 months. Mortality is very rare today and is usually due to the treatments. In general, causes related to sexually transmitted infections have a worse outcome than those caused by gastrointestinal infections. Despite a cure, recurrences occur in 25 to 50% of cases, especially those who are HLA-B27 positive. Reactivation may signal a new infection or stress. About 20% of patients have a long-term disease that results in enthesitis and destructive arthritis. Elevation of ESR, lack of response to NSAIDs, and hip joint involvement usually indicate poor outcomes.
#26 Reactive Arthritis: Practice Essentials, Background, Pathophysiology
https://emedicine.medscape.com/article/331347-overview
ReA has a variable natural history but typically follows a self-limited course, with resolution of symptoms by 3-12 months, even in patients who are acutely incapacitated. A fatal outcome is seldom reported, but death can occur, and it is usually related to the adverse effects of treatment. Postdysenteric cases are associated with a better prognosis than postvenereal cases. The presence of HLA-B27 may predict a more prolonged course and severe outcome, as may infections triggered by Yersinia, Salmonella, Shigella, or Chlamydia. […] ReA has a high tendency to recur (15-50% of cases), particularly in individuals who are HLA-B27 positive. A new infection or other stress factor could cause reactivation of the disease. […] Approximately 15-30% of patients with ReA develop a long-term, sometimes destructive, arthritis or enthesitis or spondylitis. A 1994 study analyzed 7 factors as predictors of long-term outcome in spondyloarthropathies. The number of patients with ReA in this study was low, and a valid subgroup analysis was impossible. The presence of hip-joint involvement, an ESR higher than 30, and unresponsiveness to nonsteroidal anti-inflammatory drugs (NSAIDs) probably portend a severe outcome or chronicity in ReA.
#27 Reactive Arthritis: Practice Essentials, Background, Pathophysiology
https://emedicine.medscape.com/article/331347-overview
ReA has a variable natural history but typically follows a self-limited course, with resolution of symptoms by 3-12 months, even in patients who are acutely incapacitated. A fatal outcome is seldom reported, but death can occur, and it is usually related to the adverse effects of treatment. Postdysenteric cases are associated with a better prognosis than postvenereal cases. The presence of HLA-B27 may predict a more prolonged course and severe outcome, as may infections triggered by Yersinia, Salmonella, Shigella, or Chlamydia. […] ReA has a high tendency to recur (15-50% of cases), particularly in individuals who are HLA-B27 positive. A new infection or other stress factor could cause reactivation of the disease. […] Approximately 15-30% of patients with ReA develop a long-term, sometimes destructive, arthritis or enthesitis or spondylitis. A 1994 study analyzed 7 factors as predictors of long-term outcome in spondyloarthropathies. The number of patients with ReA in this study was low, and a valid subgroup analysis was impossible. The presence of hip-joint involvement, an ESR higher than 30, and unresponsiveness to nonsteroidal anti-inflammatory drugs (NSAIDs) probably portend a severe outcome or chronicity in ReA.
#28 Reactive arthritis Information | Mount Sinai – New York
https://www.mountsinai.org/health-library/diseases-conditions/reactive-arthritis
Reactive arthritis may go away in a few weeks, but it can last for a few months and require medicines during that time. Symptoms may return over a period of years in up to one half of the people who have this condition. […] Rarely, the condition can lead to abnormal heart rhythm or problems with the aortic heart valve.
#29 Reactive Arthritis – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK499831/
Reactive arthritis usually has a self-limited course, and the symptoms resolve within 3 to 5 months. […] Symptoms lasting beyond 6 months indicate a chronic element of the disease. Sacroiliitis is the most common chronic joint involvement. Patients who are HLA-B27 positive have a higher risk of recurrence of ReA. 15-30% of patients with ReA can develop long-term arthritis or other joint abnormalities. The presence of hip involvement, unresponsiveness to NSAIDs, and ESR greater than 30 portend a worse outcome. […] The progression of reactive arthritis is variable, but in most people, the disorder is self-limited, with the resolution of the symptoms occurring by 6 to 18 months. Mortality is very rare today and is usually due to the treatments. In general, causes related to sexually transmitted infections have a worse outcome than those caused by gastrointestinal infections. Despite a cure, recurrences occur in 25 to 50% of cases, especially those who are HLA-B27 positive. Reactivation may signal a new infection or stress. About 20% of patients have a long-term disease that results in enthesitis and destructive arthritis. Elevation of ESR, lack of response to NSAIDs, and hip joint involvement usually indicate poor outcomes.
#30 Reactive Arthritis: Practice Essentials, Background, Pathophysiology
https://emedicine.medscape.com/article/331347-overview
ReA has a variable natural history but typically follows a self-limited course, with resolution of symptoms by 3-12 months, even in patients who are acutely incapacitated. A fatal outcome is seldom reported, but death can occur, and it is usually related to the adverse effects of treatment. Postdysenteric cases are associated with a better prognosis than postvenereal cases. The presence of HLA-B27 may predict a more prolonged course and severe outcome, as may infections triggered by Yersinia, Salmonella, Shigella, or Chlamydia. […] ReA has a high tendency to recur (15-50% of cases), particularly in individuals who are HLA-B27 positive. A new infection or other stress factor could cause reactivation of the disease. […] Approximately 15-30% of patients with ReA develop a long-term, sometimes destructive, arthritis or enthesitis or spondylitis. A 1994 study analyzed 7 factors as predictors of long-term outcome in spondyloarthropathies. The number of patients with ReA in this study was low, and a valid subgroup analysis was impossible. The presence of hip-joint involvement, an ESR higher than 30, and unresponsiveness to nonsteroidal anti-inflammatory drugs (NSAIDs) probably portend a severe outcome or chronicity in ReA.
#31 Reactive Arthritis – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK499831/
Reactive arthritis usually has a self-limited course, and the symptoms resolve within 3 to 5 months. […] Symptoms lasting beyond 6 months indicate a chronic element of the disease. Sacroiliitis is the most common chronic joint involvement. Patients who are HLA-B27 positive have a higher risk of recurrence of ReA. 15-30% of patients with ReA can develop long-term arthritis or other joint abnormalities. The presence of hip involvement, unresponsiveness to NSAIDs, and ESR greater than 30 portend a worse outcome. […] The progression of reactive arthritis is variable, but in most people, the disorder is self-limited, with the resolution of the symptoms occurring by 6 to 18 months. Mortality is very rare today and is usually due to the treatments. In general, causes related to sexually transmitted infections have a worse outcome than those caused by gastrointestinal infections. Despite a cure, recurrences occur in 25 to 50% of cases, especially those who are HLA-B27 positive. Reactivation may signal a new infection or stress. About 20% of patients have a long-term disease that results in enthesitis and destructive arthritis. Elevation of ESR, lack of response to NSAIDs, and hip joint involvement usually indicate poor outcomes.
#32 A Review of Reactive Arthritis
https://www.hcplive.com/view/review-reactive-arthritis
Reactive arthritis carries a good prognosis and a self-limiting course with full recovery in three to five months. […] A smaller portion of reactive arthritis patients will develop a chronic course with symptoms for more than six months. […] A small portion of reactive arthritis patients will go on to develop ankylosing spondylitis or radiological sacroiliitis. […] Poor prognostic signs include specific infections, HLA-B27 positivity, positive family history for spondyloarthritis or ankylosing spondylitis, and the presence of chronic gut inflammation. […] Data suggest that the prognosis is better for enteroarthritis than Chlamydia-induced reactive arthritis. […] The frequency of HLA-B27 among reactive arthritis patients ranges from 30-80 percent, and HLA-B27 carriers are more likely affected by severe disease, with frequent spine involvement, extra-articular features and a chronic course of arthritis. […] Persistent gut inflammation appears to play a significant role in determining the course and prognosis of reactive arthritis.
#33 Reactive Arthritis (Reiter’s Syndrome): Symptoms & Treatment
https://my.clevelandclinic.org/health/diseases/reactive-arthritis-reiters-syndrome
Reactive arthritis is usually self-limited, meaning it will clear up on its own in time (in three to 12 months). […] In a small percentage of people, Reiters syndrome seems to trigger a more serious and lasting form of spondyloarthritis. They develop long-term joint inflammation that can do real damage over time. […] It’s unclear whether this is chronic reactive arthritis or whether, in this case, you’ve developed a different disease. One autoimmune disease can trigger another, and many people have more than one.
#34 Reactive Arthritis (Reiter’s Syndrome): Symptoms & Treatment
https://my.clevelandclinic.org/health/diseases/reactive-arthritis-reiters-syndrome
Reactive arthritis is usually self-limited, meaning it will clear up on its own in time (in three to 12 months). […] In a small percentage of people, Reiters syndrome seems to trigger a more serious and lasting form of spondyloarthritis. They develop long-term joint inflammation that can do real damage over time. […] It’s unclear whether this is chronic reactive arthritis or whether, in this case, you’ve developed a different disease. One autoimmune disease can trigger another, and many people have more than one.
#35 Reactive arthritis Information | Mount Sinai – New York
https://www.mountsinai.org/health-library/diseases-conditions/reactive-arthritis
Reactive arthritis may go away in a few weeks, but it can last for a few months and require medicines during that time. Symptoms may return over a period of years in up to one half of the people who have this condition. […] Rarely, the condition can lead to abnormal heart rhythm or problems with the aortic heart valve.
#36 Elucidating potential molecular signatures through host-microbe interactions for reactive arthritis and inflammatory bowel disease using combinatorial approach | Scientific Reports
https://www.nature.com/articles/s41598-020-71674-8
Reactive Arthritis (ReA), a rare seronegative inflammatory arthritis, lacks exquisite classification under rheumatic autoimmunity. […] This study predicts the molecular signatures for ReA with co-evolved IBD through the enveloped host-microbe interactions and microbe-microbe interspecies communication, using synonymous gene expression data for selective microbes. […] Our study identified Na(+)/H(+) anti-porter (NHAA) and Kynureninase (KYNU) to be robust early and essential host-microbe interacting targets for IBD co-evolved ReA. Other vital host-microbe interacting genes, proteins, pathways and drugs include Adenosine Deaminase (ADA), Superoxide Dismutase 2 (SOD2), Catalase (CAT), Angiotensin I Converting Enzyme (ACE), carbon metabolism (folate biosynthesis) and methotrexate. These can serve as potential prognostic/theranostic biomarkers and signatures that can be extrapolated to stratify ReA and related autoimmunity patient cohorts for further pilot studies.
#37 Elucidating potential molecular signatures through host-microbe interactions for reactive arthritis and inflammatory bowel disease using combinatorial approach | Scientific Reports
https://www.nature.com/articles/s41598-020-71674-8
Reactive Arthritis (ReA), a rare seronegative inflammatory arthritis, lacks exquisite classification under rheumatic autoimmunity. […] This study predicts the molecular signatures for ReA with co-evolved IBD through the enveloped host-microbe interactions and microbe-microbe interspecies communication, using synonymous gene expression data for selective microbes. […] Our study identified Na(+)/H(+) anti-porter (NHAA) and Kynureninase (KYNU) to be robust early and essential host-microbe interacting targets for IBD co-evolved ReA. Other vital host-microbe interacting genes, proteins, pathways and drugs include Adenosine Deaminase (ADA), Superoxide Dismutase 2 (SOD2), Catalase (CAT), Angiotensin I Converting Enzyme (ACE), carbon metabolism (folate biosynthesis) and methotrexate. These can serve as potential prognostic/theranostic biomarkers and signatures that can be extrapolated to stratify ReA and related autoimmunity patient cohorts for further pilot studies.
#38 Elucidating potential molecular signatures through host-microbe interactions for reactive arthritis and inflammatory bowel disease using combinatorial approach | Scientific Reports
https://www.nature.com/articles/s41598-020-71674-8
Reactive Arthritis (ReA), a rare seronegative inflammatory arthritis, lacks exquisite classification under rheumatic autoimmunity. […] This study predicts the molecular signatures for ReA with co-evolved IBD through the enveloped host-microbe interactions and microbe-microbe interspecies communication, using synonymous gene expression data for selective microbes. […] Our study identified Na(+)/H(+) anti-porter (NHAA) and Kynureninase (KYNU) to be robust early and essential host-microbe interacting targets for IBD co-evolved ReA. Other vital host-microbe interacting genes, proteins, pathways and drugs include Adenosine Deaminase (ADA), Superoxide Dismutase 2 (SOD2), Catalase (CAT), Angiotensin I Converting Enzyme (ACE), carbon metabolism (folate biosynthesis) and methotrexate. These can serve as potential prognostic/theranostic biomarkers and signatures that can be extrapolated to stratify ReA and related autoimmunity patient cohorts for further pilot studies.
#39 Elucidating potential molecular signatures through host-microbe interactions for reactive arthritis and inflammatory bowel disease using combinatorial approach | Scientific Reports
https://www.nature.com/articles/s41598-020-71674-8
Reactive Arthritis (ReA), a rare seronegative inflammatory arthritis, lacks exquisite classification under rheumatic autoimmunity. […] This study predicts the molecular signatures for ReA with co-evolved IBD through the enveloped host-microbe interactions and microbe-microbe interspecies communication, using synonymous gene expression data for selective microbes. […] Our study identified Na(+)/H(+) anti-porter (NHAA) and Kynureninase (KYNU) to be robust early and essential host-microbe interacting targets for IBD co-evolved ReA. Other vital host-microbe interacting genes, proteins, pathways and drugs include Adenosine Deaminase (ADA), Superoxide Dismutase 2 (SOD2), Catalase (CAT), Angiotensin I Converting Enzyme (ACE), carbon metabolism (folate biosynthesis) and methotrexate. These can serve as potential prognostic/theranostic biomarkers and signatures that can be extrapolated to stratify ReA and related autoimmunity patient cohorts for further pilot studies.
#40 Elucidating potential molecular signatures through host-microbe interactions for reactive arthritis and inflammatory bowel disease using combinatorial approach | Scientific Reports
https://www.nature.com/articles/s41598-020-71674-8
Reactive Arthritis (ReA), a rare seronegative inflammatory arthritis, lacks exquisite classification under rheumatic autoimmunity. […] This study predicts the molecular signatures for ReA with co-evolved IBD through the enveloped host-microbe interactions and microbe-microbe interspecies communication, using synonymous gene expression data for selective microbes. […] Our study identified Na(+)/H(+) anti-porter (NHAA) and Kynureninase (KYNU) to be robust early and essential host-microbe interacting targets for IBD co-evolved ReA. Other vital host-microbe interacting genes, proteins, pathways and drugs include Adenosine Deaminase (ADA), Superoxide Dismutase 2 (SOD2), Catalase (CAT), Angiotensin I Converting Enzyme (ACE), carbon metabolism (folate biosynthesis) and methotrexate. These can serve as potential prognostic/theranostic biomarkers and signatures that can be extrapolated to stratify ReA and related autoimmunity patient cohorts for further pilot studies.
#41 Elucidating potential molecular signatures through host-microbe interactions for reactive arthritis and inflammatory bowel disease using combinatorial approach | Scientific Reports
https://www.nature.com/articles/s41598-020-71674-8
Reactive Arthritis (ReA), a rare seronegative inflammatory arthritis, lacks exquisite classification under rheumatic autoimmunity. […] This study predicts the molecular signatures for ReA with co-evolved IBD through the enveloped host-microbe interactions and microbe-microbe interspecies communication, using synonymous gene expression data for selective microbes. […] Our study identified Na(+)/H(+) anti-porter (NHAA) and Kynureninase (KYNU) to be robust early and essential host-microbe interacting targets for IBD co-evolved ReA. Other vital host-microbe interacting genes, proteins, pathways and drugs include Adenosine Deaminase (ADA), Superoxide Dismutase 2 (SOD2), Catalase (CAT), Angiotensin I Converting Enzyme (ACE), carbon metabolism (folate biosynthesis) and methotrexate. These can serve as potential prognostic/theranostic biomarkers and signatures that can be extrapolated to stratify ReA and related autoimmunity patient cohorts for further pilot studies.
#42 Elucidating potential molecular signatures through host-microbe interactions for reactive arthritis and inflammatory bowel disease using combinatorial approach | Scientific Reports
https://www.nature.com/articles/s41598-020-71674-8
Reactive Arthritis (ReA), a rare seronegative inflammatory arthritis, lacks exquisite classification under rheumatic autoimmunity. […] This study predicts the molecular signatures for ReA with co-evolved IBD through the enveloped host-microbe interactions and microbe-microbe interspecies communication, using synonymous gene expression data for selective microbes. […] Our study identified Na(+)/H(+) anti-porter (NHAA) and Kynureninase (KYNU) to be robust early and essential host-microbe interacting targets for IBD co-evolved ReA. Other vital host-microbe interacting genes, proteins, pathways and drugs include Adenosine Deaminase (ADA), Superoxide Dismutase 2 (SOD2), Catalase (CAT), Angiotensin I Converting Enzyme (ACE), carbon metabolism (folate biosynthesis) and methotrexate. These can serve as potential prognostic/theranostic biomarkers and signatures that can be extrapolated to stratify ReA and related autoimmunity patient cohorts for further pilot studies.
#43 Elucidating potential molecular signatures through host-microbe interactions for reactive arthritis and inflammatory bowel disease using combinatorial approach | Scientific Reports
https://www.nature.com/articles/s41598-020-71674-8
The management of rare complex overlapping autoimmune disorder ReA so as to prevent its progression and recurrence depends on the detailed microbiome association studies with the host genetics structuring the immunogenic trends. […] The current work on host-microbe interactions provides a starting point for researchers and clinicians to investigate Inflammatory Bowel Disease (IBD) associated Reactive Arthritis (ReA). […] These predictions substantially furnish the intricate details of the cross-talk between post-infectious inflammatory reactions with shared patho-immunogenesis as the starting point for researchers and clinicians for detailed and newer experimental analysis. Future studies are required on larger cohort of patients having ReA due to IBD in order to have validated outputs of the predictive network.
#44 Elucidating potential molecular signatures through host-microbe interactions for reactive arthritis and inflammatory bowel disease using combinatorial approach | Scientific Reports
https://www.nature.com/articles/s41598-020-71674-8
The management of rare complex overlapping autoimmune disorder ReA so as to prevent its progression and recurrence depends on the detailed microbiome association studies with the host genetics structuring the immunogenic trends. […] The current work on host-microbe interactions provides a starting point for researchers and clinicians to investigate Inflammatory Bowel Disease (IBD) associated Reactive Arthritis (ReA). […] These predictions substantially furnish the intricate details of the cross-talk between post-infectious inflammatory reactions with shared patho-immunogenesis as the starting point for researchers and clinicians for detailed and newer experimental analysis. Future studies are required on larger cohort of patients having ReA due to IBD in order to have validated outputs of the predictive network.
#45 A Review of Reactive Arthritis
https://www.hcplive.com/view/review-reactive-arthritis
Reactive arthritis carries a good prognosis and a self-limiting course with full recovery in three to five months. […] A smaller portion of reactive arthritis patients will develop a chronic course with symptoms for more than six months. […] A small portion of reactive arthritis patients will go on to develop ankylosing spondylitis or radiological sacroiliitis. […] Poor prognostic signs include specific infections, HLA-B27 positivity, positive family history for spondyloarthritis or ankylosing spondylitis, and the presence of chronic gut inflammation. […] Data suggest that the prognosis is better for enteroarthritis than Chlamydia-induced reactive arthritis. […] The frequency of HLA-B27 among reactive arthritis patients ranges from 30-80 percent, and HLA-B27 carriers are more likely affected by severe disease, with frequent spine involvement, extra-articular features and a chronic course of arthritis. […] Persistent gut inflammation appears to play a significant role in determining the course and prognosis of reactive arthritis.
#46 Reactive Arthritis – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK499831/
Reactive arthritis usually has a self-limited course, and the symptoms resolve within 3 to 5 months. […] Symptoms lasting beyond 6 months indicate a chronic element of the disease. Sacroiliitis is the most common chronic joint involvement. Patients who are HLA-B27 positive have a higher risk of recurrence of ReA. 15-30% of patients with ReA can develop long-term arthritis or other joint abnormalities. The presence of hip involvement, unresponsiveness to NSAIDs, and ESR greater than 30 portend a worse outcome. […] The progression of reactive arthritis is variable, but in most people, the disorder is self-limited, with the resolution of the symptoms occurring by 6 to 18 months. Mortality is very rare today and is usually due to the treatments. In general, causes related to sexually transmitted infections have a worse outcome than those caused by gastrointestinal infections. Despite a cure, recurrences occur in 25 to 50% of cases, especially those who are HLA-B27 positive. Reactivation may signal a new infection or stress. About 20% of patients have a long-term disease that results in enthesitis and destructive arthritis. Elevation of ESR, lack of response to NSAIDs, and hip joint involvement usually indicate poor outcomes.
#47 Reactive Arthritis – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK499831/
Reactive arthritis usually has a self-limited course, and the symptoms resolve within 3 to 5 months. […] Symptoms lasting beyond 6 months indicate a chronic element of the disease. Sacroiliitis is the most common chronic joint involvement. Patients who are HLA-B27 positive have a higher risk of recurrence of ReA. 15-30% of patients with ReA can develop long-term arthritis or other joint abnormalities. The presence of hip involvement, unresponsiveness to NSAIDs, and ESR greater than 30 portend a worse outcome. […] The progression of reactive arthritis is variable, but in most people, the disorder is self-limited, with the resolution of the symptoms occurring by 6 to 18 months. Mortality is very rare today and is usually due to the treatments. In general, causes related to sexually transmitted infections have a worse outcome than those caused by gastrointestinal infections. Despite a cure, recurrences occur in 25 to 50% of cases, especially those who are HLA-B27 positive. Reactivation may signal a new infection or stress. About 20% of patients have a long-term disease that results in enthesitis and destructive arthritis. Elevation of ESR, lack of response to NSAIDs, and hip joint involvement usually indicate poor outcomes.
#48 Reactive Arthritis: Update
https://pmc.ncbi.nlm.nih.gov/articles/PMC7519381/
Generally, the course of ReA is highly variable, whether it is disease duration, frequency, or severity of relapses. As suggested, most patients have completed remission within 612 months. However, 30 to 63% of patients develop chronic ReA remaining more than 6 months and require retreatment. Some of these patients may develop signs and symptoms of AS or inflammatory bowel disease. […] Regarding the predictive factors of worse prognosis of ReA, HLA-B27 positivity, Chlamydia-induced infection, spondyloarthropathy family history, and chronic bowel inflammation were the factors that contribute the most to severity and progression of the disease.
#49 A Review of Reactive Arthritis
https://www.hcplive.com/view/review-reactive-arthritis
Reactive arthritis carries a good prognosis and a self-limiting course with full recovery in three to five months. […] A smaller portion of reactive arthritis patients will develop a chronic course with symptoms for more than six months. […] A small portion of reactive arthritis patients will go on to develop ankylosing spondylitis or radiological sacroiliitis. […] Poor prognostic signs include specific infections, HLA-B27 positivity, positive family history for spondyloarthritis or ankylosing spondylitis, and the presence of chronic gut inflammation. […] Data suggest that the prognosis is better for enteroarthritis than Chlamydia-induced reactive arthritis. […] The frequency of HLA-B27 among reactive arthritis patients ranges from 30-80 percent, and HLA-B27 carriers are more likely affected by severe disease, with frequent spine involvement, extra-articular features and a chronic course of arthritis. […] Persistent gut inflammation appears to play a significant role in determining the course and prognosis of reactive arthritis.