What is the treatment for reactive arthritis?

• A. Treat underlying cause and NSAIDs; can use low dose prednisone
• B. Antibiotics alone
• C. High-dose prednisone as sole therapy
• D. DMARDs as first line

Answer: (A)

Reactive arthritis is an inflammatory arthritis that follows an infection, and the goal of treatment is to reduce inflammation while addressing any ongoing triggering infection. The best initial approach is NSAIDs to relieve pain and swelling. If symptoms persist, a short course of low-dose systemic steroids (or local corticosteroid injections) can help control joint inflammation. Antibiotics are not used alone to treat the arthritis; they are only helpful if there is an ongoing infection contributing to the trigger, and they don’t reliably resolve the arthritis by themselves. High-dose prednisone used as the sole therapy is not the standard approach. For patients with persistent or recurrent disease, disease-modifying antirheumatic drugs (DMARDs) or biologics may be considered, but these are not first-line.