Chikungunya infection in the general population and in patients with rheumatoid arthritis on biological therapy

Clin Rheumatol. 2015 Jul;34(7):1285-7. doi: 10.1007/s10067-015-2979-x. Epub 2015 May 28.

Abstract

Chikungunya infection is a febrile illness, which currently is afflicting the Caribbean islands including the Dominican Republic. We would like to report our experience with Chikungunya-related musculoskeletal manifestations in our arthritis clinics in the Dominican Republic. A total of 514 patients presented for the first time to our arthritis clinic exhibiting musculoskeletal manifestations, 473/514 (92%) exhibiting symmetric polyarthralgias, 344/514 (67%) arthritis, and 385 (75%) skin rash. The great majority 457.46 (89%) exhibited very good clinical response to nonsteroidal anti-inflammatory drugs (NSAIDs), 370 (72%) require low-dose steroids, and only 5 patients (0.97%) required methotrexate therapy. In addition, of a total of 328 patients with rheumatoid arthritis on biological treatment, 53 exhibited Chikungunya-related musculoskeletal manifestations; 51/53 (96.2%) exhibited symmetric polyarthralgias, 25/53 (47.1%) arthritis, and 13/53 (24.5%) tendinopathy. Of most patients, 51/53 responded to NSAIDs, of which, 23 patients only responded partially, and in total 25 (47.1%) required low-dose steroids. Disease-modifying antirheumatic drug (DMARD) therapy including biologics remained unchanged in this population.

MeSH terms

  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Antirheumatic Agents / therapeutic use
  • Arthralgia / drug therapy
  • Arthralgia / epidemiology
  • Arthritis, Rheumatoid / complications*
  • Arthritis, Rheumatoid / drug therapy*
  • Arthritis, Rheumatoid / virology
  • Biological Therapy / methods*
  • Chikungunya Fever / complications*
  • Chikungunya Fever / epidemiology*
  • Disease Outbreaks
  • Dominican Republic
  • Female
  • Humans
  • Male
  • Methotrexate / therapeutic use
  • Middle Aged
  • Musculoskeletal Diseases / complications
  • Musculoskeletal Diseases / drug therapy
  • Musculoskeletal Diseases / epidemiology
  • Steroids / therapeutic use

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Antirheumatic Agents
  • Steroids
  • Methotrexate