Chikungunya Infection in Rheumatoid Arthritis Patients Save

Chikungunya virus (CKV) is an acute febrile illness caused by an alpha virus that mimics RA in its clinical presentation. Incidence of CKV fever in the Carribean islands continues to rise steadily since 2013.In the general population, articular manifestations of CKV are transient and respond well to symptomatic treatment. But is it safe to say that the disease course and treatment response is comparable in patients with pre-existing inflammatory arthritis? Do biologic treatments on board alter clinical presentation and outcomes?

A rheumatology group in the Dominican Republic observed 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. After 10 month of observation, majority of RA patients responded to symptomatic therapy and there was no need for expansion of their conventional and/or biologic DMARD regimen.