Reduced Duration of Postchikungunya Musculoskeletal Pain in Rheumatological Patients Treated with Biologicals

Chikungunya fever (CHIK) has caused important epidemic outbreaks in the Americas, with musculoskeletal involvement being the main manifestation, causing chronic symptoms in half of the affected patients. This study was performed to evaluate the clinical course of the infection in 168 patients with a...

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Main Authors: Carlos A. A. de Brito, Claudia D. L. Marques, Rafael F. O. França, Janaína R. Monteiro, Marina C. M. de Brito, Fabiana Lopes, Anton Lima, Gabriel L. Marques, Maria Luisa Valadares, Angela L. B. P. Duarte
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:Journal of Tropical Medicine
Online Access:http://dx.doi.org/10.1155/2020/2071325
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author Carlos A. A. de Brito
Claudia D. L. Marques
Rafael F. O. França
Janaína R. Monteiro
Marina C. M. de Brito
Fabiana Lopes
Anton Lima
Gabriel L. Marques
Maria Luisa Valadares
Angela L. B. P. Duarte
author_facet Carlos A. A. de Brito
Claudia D. L. Marques
Rafael F. O. França
Janaína R. Monteiro
Marina C. M. de Brito
Fabiana Lopes
Anton Lima
Gabriel L. Marques
Maria Luisa Valadares
Angela L. B. P. Duarte
author_sort Carlos A. A. de Brito
collection DOAJ
description Chikungunya fever (CHIK) has caused important epidemic outbreaks in the Americas, with musculoskeletal involvement being the main manifestation, causing chronic symptoms in half of the affected patients. This study was performed to evaluate the clinical course of the infection in 168 patients with autoimmune inflammatory disease using biological disease-modifying antirheumatic drugs (bDMARDs), comparing this group with 56 household controls. Anti-CHIKV IgG serology was positive in 42 (25%) of the patients in the bDMARD group and in 15 (27%) of the controls (p=0.79). Of those with positive serology, 32 (76%) and 14 (93%) were symptomatic among subjects in the bDMARD and control groups, respectively (p=0.87). Persistence of musculoskeletal symptoms for more than three months occurred in 64% of the patients in the control group and only in 28% in the bDMARD group (p=0.021), maintaining a statistically significant difference only for users of anti-TNF. This study found that patients affected by chikungunya fever using bDMARDs did not present severe forms or complications in the acute phase of the disease, and patients using anti-TNF biologicals had a lower frequency of chronic joint symptoms than the household controls. This favorable outcome may be related to the cytokine blockade, with a reduction in the inflammatory response and joint damage.
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spelling doaj-art-9c2490eec0534d63be28aaaf0115685f2025-08-20T03:38:15ZengWileyJournal of Tropical Medicine1687-96861687-96942020-01-01202010.1155/2020/20713252071325Reduced Duration of Postchikungunya Musculoskeletal Pain in Rheumatological Patients Treated with BiologicalsCarlos A. A. de Brito0Claudia D. L. Marques1Rafael F. O. França2Janaína R. Monteiro3Marina C. M. de Brito4Fabiana Lopes5Anton Lima6Gabriel L. Marques7Maria Luisa Valadares8Angela L. B. P. Duarte9Internal Medicine, Clinical Hospital of Federal University of Pernambuco and Autoimmune Institute, Recife, Pernambuco, BrazilRheumatology Service, Clinical Hospital of Federal University of Pernambuco, Recife, Pernambuco, BrazilDepartment of Virology and Experimental Therapy, Aggeu Magalhães Institute, Oswaldo Cruz Foundation (FIOCRUZ), Recife, Pernambuco, BrazilFederal University of Pernambuco, Recife, Pernambuco, BrazilFederal University of Pernambuco, Recife, Pernambuco, BrazilFederal University of Pernambuco, Recife, Pernambuco, BrazilFederal University of Pernambuco, Recife, Pernambuco, BrazilUniversidade Católica de Pernambuco (UNICAP), Recife, Pernambuco, BrazilFaculdade de Medicina de Olinda (FMO), Olinda, Pernambuco, BrazilRheumatology Service, Clinical Hospital of Federal University of Pernambuco, Recife, Pernambuco, BrazilChikungunya fever (CHIK) has caused important epidemic outbreaks in the Americas, with musculoskeletal involvement being the main manifestation, causing chronic symptoms in half of the affected patients. This study was performed to evaluate the clinical course of the infection in 168 patients with autoimmune inflammatory disease using biological disease-modifying antirheumatic drugs (bDMARDs), comparing this group with 56 household controls. Anti-CHIKV IgG serology was positive in 42 (25%) of the patients in the bDMARD group and in 15 (27%) of the controls (p=0.79). Of those with positive serology, 32 (76%) and 14 (93%) were symptomatic among subjects in the bDMARD and control groups, respectively (p=0.87). Persistence of musculoskeletal symptoms for more than three months occurred in 64% of the patients in the control group and only in 28% in the bDMARD group (p=0.021), maintaining a statistically significant difference only for users of anti-TNF. This study found that patients affected by chikungunya fever using bDMARDs did not present severe forms or complications in the acute phase of the disease, and patients using anti-TNF biologicals had a lower frequency of chronic joint symptoms than the household controls. This favorable outcome may be related to the cytokine blockade, with a reduction in the inflammatory response and joint damage.http://dx.doi.org/10.1155/2020/2071325
spellingShingle Carlos A. A. de Brito
Claudia D. L. Marques
Rafael F. O. França
Janaína R. Monteiro
Marina C. M. de Brito
Fabiana Lopes
Anton Lima
Gabriel L. Marques
Maria Luisa Valadares
Angela L. B. P. Duarte
Reduced Duration of Postchikungunya Musculoskeletal Pain in Rheumatological Patients Treated with Biologicals
Journal of Tropical Medicine
title Reduced Duration of Postchikungunya Musculoskeletal Pain in Rheumatological Patients Treated with Biologicals
title_full Reduced Duration of Postchikungunya Musculoskeletal Pain in Rheumatological Patients Treated with Biologicals
title_fullStr Reduced Duration of Postchikungunya Musculoskeletal Pain in Rheumatological Patients Treated with Biologicals
title_full_unstemmed Reduced Duration of Postchikungunya Musculoskeletal Pain in Rheumatological Patients Treated with Biologicals
title_short Reduced Duration of Postchikungunya Musculoskeletal Pain in Rheumatological Patients Treated with Biologicals
title_sort reduced duration of postchikungunya musculoskeletal pain in rheumatological patients treated with biologicals
url http://dx.doi.org/10.1155/2020/2071325
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