Effect of a three month course of ciprofloxacin on the outcome of reactive arthritis
- T Yli-Kerttulaa,
- R Luukkainend,
- U Yli-Kerttulae,
- T Möttönena,
- M Hakolaf,
- M Korpelae,
- M Sanilad,
- J Parviaineng,
- J Uksilab,
- R Vainionpääc,
- A Toivanena
- aDepartment of Medicine, Turku University, Finland, bDepartment of Medical Microbiology, Turku University, cDepartment of Virology, Turku University, dSatalinna Hospital, Finland, eDepartment of Medicine, Section of Rheumatology, Tampere University Hospital, Finland, fJyväskylä Central Hospital, Finland, gStat-X, Finland
- Dr Timo Yli-Kerttula, Department of Medicine, Turku University, Kiinamyllynkatu 4–8, FIN-20520 Turku, Finland Email: timo.yli-kerttula{at}utu.fi
- Accepted 31 January 2000
Abstract
BACKGROUND Treatment of reactive arthritis (ReA) with antibiotics has so far remained controversial. Eradication of the causative microbe appears logical, but short term antibiotic treatment has no beneficial effect on the outcome of ReA.
OBJECTIVE To evaluate the effect of a three month course of ciprofloxacin on ReA.
METHODS In a randomised, double blind, placebo controlled trial, between December 1992 and February 1996, 71 patients with acute ReA triggered by a gastrointestinal or a urogenital infection were randomly assigned to receive ciprofloxacin 500 mg or placebo twice daily for three months. Patients were assessed at study entry, at 6 weeks, 3 months, 6 months, and 12 months. Sixty two patients were valid for the efficacy analysis. The primary outcome measures were erythrocyte sedimentation rate, number of swollen joints, patients self assessment, and complete recovery.
RESULTS Adverse events were mostly mild and occurred in both treatment groups. There were no statistically significant differences in any of the primary or secondary efficacy variables between the study groups at baseline or during the 12 month follow up. All primary outcome measures indicated that the condition of the patients improved during the study.
CONCLUSION Both groups tended to recover. Ciprofloxacin, given as a three month course, had no advantage over placebo treatment.
Footnotes
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All the authors contributed to the design, analysis, and writing of the report. Auli Toivanen was the principal investigator. Clinical assessments of the patients were performed by Timo Yli-Kerttula, Reijo Luukkainen, Urpo Yli-Kerttula, Timo Möttönen, Mikko Hakola, Markku Korpela, and Markku Sanila. Jaakko Uksila and Raija Vainionpää carried out the serum antibody determinations. Data collection and statistical analysis were performed by Jouni Parviainen.
