Treatment of Chronic Chikungunya Arthritis With Methotrexate: A Systematic Review

Amaral, J. Kennedy; Sutaria, Ravi; Schoen, Robert T.

doi:10.1002/acr.23519

Cited by 50 publications

(26 citation statements)

References 54 publications

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“…The observation that the group of SOT recipients analyzed in this study showed a lower incidence of chronic arthralgia supports the hypothesis of host autoimmunity as a cause of chronic inflammatory arthritis in patients’ CHIKV infection. Several autoimmune‐like inflammatory processes have been described and a resemblance with the risk factors for rheumatoid arthritis has been pointed out previously in the literature . Our results suggest that immunosuppressive therapy could reduce the inflammatory response that causes arthritis and other severe manifestations of CHIKV infection, explaining the milder course of the disease in this population of patients.…”

Section: Discussionsupporting

confidence: 79%

“…Several autoimmune-like inflammatory processes have been described and a resemblance with the risk factors for rheumatoid arthritis has been pointed out previously in the literature. 30 Our results suggest that immunosuppressive therapy could reduce the inflammatory response that causes arthritis and other severe manifestations of CHIKV infection, explaining the milder course of the disease in this population of patients.…”

Section: Impact Of Immunosuppressant Use In the Clinical Manifestatmentioning

confidence: 59%

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Chikungunya in solid organ transplant recipients, a case series and literature review

Rosso

Rodríguez

Cedano

et al. 2018

Transplant Infectious Dis

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Chikungunya virus is a recent emerging arbovirus in Latin America, and the clinical manifestations can vary from fever and rash to severe chronic inflammatory arthritis. Few reports have been published regarding this infection in immunocompromised patients, including solid organ transplant recipients. We report a case series of solid organ transplant recipients with confirmed Chikungunya infection by positive reverse transcription polymerase chain reaction (RT-PCR), identified between January 2014 and December 2016. In addition, we conducted a literature review searching PubMed, EMBASE, and LILACS databases on Chikungunya infection in solid organ transplant recipients. Ten solid organ transplant recipients were included, consisting of 5 kidney, 4 liver, and 1 liver/kidney transplant recipient. Mean age of the transplant recipients was 47 years, and the most frequent symptoms of Chikungunya infection were arthralgia and fever. None of the patients required treatment in the intensive care unit, no deaths or graft rejection occurred. None of our patients had recurrent arthritis during 3-month follow-up period after the infection. Twenty-one cases of Chikungunya virus were identified in the literature review. Most cases had a benign clinical course with no severe complications, death, or chronic inflammatory arthritis. In conclusion, Chikungunya infection in solid organ transplant recipients has a benign course and has no chronic recurrent arthritis. It is possible that the immunosuppression regimen could decrease the risk of severe or chronic inflammatory manifestations in solid organ transplant recipients infected with Chikungunya.

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Section: Discussionsupporting

confidence: 79%

Section: Impact Of Immunosuppressant Use In the Clinical Manifestatmentioning

confidence: 59%

Chikungunya in solid organ transplant recipients, a case series and literature review

Rosso

Rodríguez

Cedano

et al. 2018

Transplant Infectious Dis

View full text Add to dashboard Cite

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“…Current evidence supports MTX as a potential treatment of viruses mediated arthritis, specifically Parvovirus B19, HBV, HCV, and HIV [185]. Studies documented that pro-inflammatory mediators were markedly decreased after MTX treatment in virus-induced arthritis [186]. As a remark, recent studies suggest that hepatitis B reactivation or on accelerated liver disease are rather infrequent manifestations during long-term MTX treatment [187].…”

Section: Methotrexatementioning

confidence: 96%

The anti-viral facet of anti-rheumatic drugs: Lessons from COVID-19

Perricone

Triggianese

Bartoloni

et al. 2020

Journal of Autoimmunity

128

131

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“…Moreover, few prospective studies have evaluated drug efficacy, and these studies have several limitations, including the use of different methodologies, the lack of adequate randomization in some studies, different therapeutic doses, short follow-up times, and sometimes, a small number of cases or heterogeneous comparison groups, that make comparisons difficult. There are also other case-series studies and reported experiences of pain management experienced in epidemics 14,[20][21][22][23][24][25][26][27][28][29] .…”

Section: A Therapeutic Approach To Musculoskeletal Manifestationsmentioning

confidence: 99%

Update on the treatment of musculoskeletal manifestations in chikungunya fever: a guideline

Brito

Marques

Falcão

et al. 2020

Rev. Soc. Bras. Med. Trop.

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Since the emergence of the chikungunya virus in Brazil in 2014, more than 700,000 cases have been reported throughout the country, corresponding to one-third of all cases reported in the Americas. In addition to its high attack rates, resulting in hundreds of thousands of cases, the disease has high chronicity rates with persistent joint manifestations for more than 3 months, which can spread to more than half of the patients affected in the acute phase. Pain associated with musculoskeletal manifestations, often disabling, has an effect on patients' quality of life at different stages of the disease. Currently, the challenge faced by specialists is identifying the best therapy to be instituted for symptom relief despite the limited number of published intervention studies. In 2016, a multidisciplinary group published pharmacological treatment protocols for pain in patients with chikungunya, which was incorporated into the guidelines for clinical management of the Brazilian Ministry of Health in 2017; in that same year, a consensus was published by the Brazilian Society of Rheumatology about diagnosis and treatment. After 5 years of experience with chikungunya epidemics, in 2019, specialists involved in the protocols of the Brazilian Society of Rheumatology and Brazilian Ministry of Health prepared an update with the main objective of developing flowcharts for the therapeutic approach of musculoskeletal manifestations in adult patients to enable specialists at different levels of healthcare to spread and apply this guideline in a systematic and simplified manner.

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Treatment of Chronic Chikungunya Arthritis With Methotrexate: A Systematic Review

Cited by 50 publications

References 54 publications

Chikungunya in solid organ transplant recipients, a case series and literature review

Chikungunya in solid organ transplant recipients, a case series and literature review

The anti-viral facet of anti-rheumatic drugs: Lessons from COVID-19

Update on the treatment of musculoskeletal manifestations in chikungunya fever: a guideline

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