Department of Biology and Biochemistry, South Kazakhstan Medical Academy, Shymkent, Kazakhstan.
Byramjee Jeejeebhoy Government Medical College and Sassoon General Hospitals, Pune, India.
J Korean Med Sci. 2022 Dec 26;37(50):e355. doi: 10.3346/jkms.2022.37.e355.
Reactive arthritis (ReA) is an often neglected disease that received some attention during the coronavirus disease 2019 (COVID-19) pandemic. There is some evidence that infection with severe acute respiratory syndrome coronavirus 2 can lead to "reactive" arthritis. However, this does not follow the classical definition of ReA that limits the organisms leading to this condition. Also, there is no recommendation by any international society on the management of ReA during the current pandemic. Thus, a survey was conducted to gather information about how modern clinicians across the world approach ReA.
An e-survey was carried out based on convenient sampling via social media platforms. Twenty questions were validated on the pathogenesis, clinical presentation, and management of ReA. These also included information on post-COVID-19 arthritis. Duplicate entries were prevented and standard guidelines were followed for reporting internet-based surveys.
There were 193 respondents from 24 countries. Around one-fifth knew the classical definition of ReA. Nearly half considered the triad of conjunctivitis, urethritis and asymmetric oligoarthritis a "must" for diagnosis of ReA. Other common manifestations reported include enthesitis, dermatitis, dactylitis, uveitis, and oral or genital ulcers. Three-fourths opined that no test was specific for ReA. Drugs for ReA were non-steroidal anti-inflammatory drugs, intra-articular injections, and conventional disease-modifying agents with less than 10% supporting biological use.
The survey brought out the gap in existing concepts of ReA. The current definition needs to be updated. There is an unmet need for consensus recommendations for the management of ReA, including the use of biologicals.
反应性关节炎（ReA）是一种常被忽视的疾病，在 2019 年冠状病毒病（COVID-19）大流行期间受到了一些关注。有一些证据表明，严重急性呼吸综合征冠状病毒 2 的感染可能导致“反应性”关节炎。然而，这并不符合将导致这种情况的生物体限制在特定范围内的经典 ReA 定义。此外，目前没有任何国际社会就大流行期间 ReA 的管理提出建议。因此，进行了一项调查，以收集有关世界各地的现代临床医生如何处理 ReA 的信息。
通过社交媒体平台进行了基于方便抽样的电子调查。对 ReA 的发病机制、临床表现和管理进行了 20 个问题的验证，其中还包括了 COVID-19 后关节炎的信息。为防止重复输入，遵循了互联网调查报告的标准准则。
来自 24 个国家的 193 名受访者。约五分之一的人知道 ReA 的经典定义。近一半的人认为结膜炎、尿道炎和不对称少关节炎三联征是诊断 ReA 的“必备”条件。报告的其他常见表现包括附着点炎、皮疹、指（趾）炎、葡萄膜炎和口腔或生殖器溃疡。四分之三的人认为没有特定的测试用于 ReA。用于 ReA 的药物是非甾体抗炎药、关节内注射和传统的疾病修饰药物，支持使用生物制剂的不到 10%。
该调查揭示了现有 ReA 概念的差距。当前的定义需要更新。需要达成共识，制定 ReA 管理的推荐意见，包括生物制剂的使用。
