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

• Published in: Current rheumatology reports 2021-06, Vol.23 (6), p.39-39, Article 39
• Main Authors: Abdelghani, Kawther Ben, Nacef, Lilia, Miladi, Saoussen, Sellami, Meriem, Ouenniche, Kmar, Souabni, Leila, Kassab, Selma, Chekili, Selma, Fazaa, Alia, Laatar, Ahmed
• Format: Article
• Language: English
• Subjects: Medicine; Medicine & Public Health; Reactive Arthritis (H Zeidler; Rheumatology; Section Editor; Topical Collection on Reactive Arthritis
• ISSN: 1523-3774; 1534-6307
• DOI: 10.1007/s11926-021-01004-y

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.