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Reactive Arthritis following Bacillus Calmette–Guerin Therapy for Bladder Cancer: a Systematic Literature Review

  • Reactive Arthritis (H Zeidler, Section Editor)
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Abstract

Purpose of Review

Intravesical BCG therapy (ivBCG) is a treatment for bladder cancer that complements surgery and prevents tumor progression. Reactive arthritis (ReA) is a rare osteoarticular manifestation that can complicate this treatment. An updated systematic literature review has been investigated to identify clinical, biological, and therapeutic data of this pathology.

Recent Findings

A systematic literature was performed on October 2020 to identify papers published from 2000 to 2020. Study eligibility criteria included case reports, case series, cohort studies, systematic reviews, meta-analysis, and letters to the editor, in English and French. Independent extraction of articles was performed by two investigators. Thirteen studies met the search criteria for the systematic review with a good quality assessment. The total number of patients was 107, with an average age of 61.5 [24–80]. The symptoms of ReA appeared after a mean number of 5.71 instillations and 13.9 days. Arthritis was the most common symptom (98.13%) followed by fever (80.76%) and conjunctivitis (64.42%). Human leukocyte antigen (HLAB27) was positive in 28.97% of patients. Therapeutic modalities included non-steroidal anti-inflammatory drugs (NSAIDs) (51.4%), corticosteroids (27.1%), conventional synthetic disease-modifying antirheumatic drugs (3.84%), antitubercular drugs (14.42%), and tocilizumab (0.93%). BCG therapy was discontinued in 29.9% of patients. Remission was achieved in 92.3% of patients and one patient progressed to spondyloarthritis.

Summary

ReA is a rare complication of BCG therapy. Clinical signs are similar to those of typical ReA and treatment is primarily based on NSAIDs and corticosteroids.

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Authors and Affiliations

  1. Rheumatology Department, Mongi Slim Hospital, La Marsa, Tunisia

    Kawther Ben Abdelghani, Lilia Nacef, Saoussen Miladi, Meriem Sellami, Kmar Ouenniche, Leila Souabni, Selma Kassab, Selma Chekili, Alia Fazaa & Ahmed Laatar

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Correspondence to Lilia Nacef.

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Abdelghani, K.B., Nacef, L., Miladi, S. et al. Reactive Arthritis following Bacillus Calmette–Guerin Therapy for Bladder Cancer: a Systematic Literature Review. Curr Rheumatol Rep 23, 39 (2021). https://doi.org/10.1007/s11926-021-01004-y

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