Advances in Rheumatology (Nov 2022)

Treatment with biological therapy is associated with faster recovery and lower frequency of treatment switch among rheumatic patients with Chikungunya fever

  • Aline Ranzolin,
  • Claudia Diniz Lopes Marques,
  • Laurindo Ferreira da Rocha Junior,
  • Angela Luzia Branco Pinto Duarte,
  • Hugo Deleon de Lima,
  • Lays Miranda de Almeida Martins,
  • Anderson Rodrigues de Almeida,
  • Priscilla Stela Santana de Oliveira,
  • Moacyr Jesus Barreto de Melo Rêgo,
  • Maira Galdino da Rocha Pitta,
  • Markus Bredemeier,
  • Ieda Maria Magalhães Laurindo

DOI
https://doi.org/10.1186/s42358-022-00273-0
Journal volume & issue
Vol. 62, no. 1
pp. 1 – 7

Abstract

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Abstract Background/Objective The effects of Chikungunya virus (CHIKV) infection on patients with rheumatic diseases have not been extensively studied. Our aim was to compare the clinical course of patients with rheumatoid arthritis and spondyloarthritis, categorized according to the use or not of biologic disease modifying anti-rheumatic drugs (bDMARDs), during and after infection by CHIKV. Methods Patients from a northeastern Brazilian city that suffered an epidemic outbreak of Chikungunya fever (CHIK) between Oct 2015 and Jul 2016, on regular follow-up in a longitudinal registry of rheumatic patients (BiobadaBrasil), were invited to participate. Participants underwent a standardized clinical interview and collection of blood sample for serological tests (IgM/IgG) for CHIKV. A positive IgG was considered evidence of previous CHIKV infection. Results 105 patients (84 with rheumatoid arthritis, 17 with ankylosing spondylitis, and 4 with psoriatic arthritis) were evaluated. Most patients (58, 55.2%) were on therapy with bDMARDs. The overall prevalence of seropositivity for CHIKV was 47.6% (39.7% in patients on bDMARDs and 57.4% in those exclusively on conventional synthetic (cs-) DMARDs (p = 0.070). Among seropositive patients, asymptomatic disease had similar frequency in those treated and not treated with bDMARDs (39.1% versus 33.3%, respectively; p = 0.670). However, patients exclusively on csDMARDs presented significantly higher prevalence of articular symptoms beyond 3 months and switched treatment more often than patients on bDMARDs (p < 0.05 for both comparisons). Conclusions Among rheumatic patients with CHIK, those on bDMARDs had shorter persistence of articular symptoms and switched treatment scheme less often than patients exclusively treated with csDMARDs.

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