Treatment of joint manifestations in the chronic phase of chikungunya fever
Abstract
Chikungunya fever is caused by an RNA arbovirus belonging to the Togaviridae family of the alphavirus genus, called "chikungunya virus", this virus is vectored by Aedes aegypti and Aedes albopictus. In its acute phase, the disease is manifested by fever, arthritis or severe arthralgia, myalgia, headache, photophobia, lymphadenopathy and skin rashes. The symptoms can progress to a subacute to chronic phase, where joint manifestations and fatigue persist. A bibliographic search was carried out in the PubMed, Cochrane, Dovepress and SciELO databases, using the keywords: chikungunya and chikunguña, crossed with the words: chronic arthritis and treatment. A total of 16 articles were included: 6 review articles, 1 systematic review, 4 original articles, 2 clinical trials, 1 letter to Editor letter and 2 case reports. Among the pharmacological options, methotrexate is the most studied drug and competes with the effects of NSAIDs. Non-pharmacological therapies are physiotherapy and physical therapy, used as complements to pharmacological therapy. The use of home therapies, including homeopathy, could also be added, mainly addressing the psychological and cultural factors of the patients.
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References
(1) Pathak H, Mohan MC, Ravindran V. Chikungunya arthritis. Clin Med (Lond) [Internet]. septiembre de 2019 [citado 11 de junio de 2023];19(5):381-5. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6771335/
(2) Millsapps EM, Underwood EC, Barr KL. Development and application of treatment for chikungunya fever. RRTM [Internet]. 16 de diciembre de 2022 [citado 11 de junio de 2023];13:55-66. Disponible en: https://www.dovepress.com/development-and-application-of-treatment-for-chikungunya-fever-peer-reviewed-fulltext-article-RRTM
(3) Neumann IL, de Oliveira DA, de Barros EL, da S Santos G, de Oliveira LS, Duarte AL, et al. Resistance exercises improve physical function in chronic Chikungunya fever patients: a randomized controlled trial. Eur J Phys Rehabil Med. agosto de 2021;57(4):620-9.
(4) Meza N, Manzur Barbur MC, Mejía Sanjuanelo AM. Chikunguña, manifestaciones en el sistema nervioso. Acta Neurológica Colombiana [Internet]. mayo de 2021 [citado 11 de junio de 2023];37(1):35-9. Disponible en: http://www.scielo.org.co/scielo.php?script=sci_abstract&pid=S0120-87482021000200035&lng=en&nrm=iso&tlng=es
(5) Kumar R, Ahmed S, Parray HA, Das S. Chikungunya and arthritis: An overview. Travel Med Infect Dis. 2021;44:102168.
(6) Silva-Filho E, Okano AH, Morya E, Albuquerque J, Cacho E, Unal G, et al. Neuromodulation treats Chikungunya arthralgia: a randomized controlled trial. Sci Rep [Internet]. 30 de octubre de 2018 [citado 11 de junio de 2023];8(1):16010. Disponible en: https://www.nature.com/articles/s41598-018-34514-4
(7) Singh P, Chhabra M, Mittal V, Sharma P, Rizvi MA, Chauhan LS, et al. Current research and clinical trials for a vaccine against Chikungunya virus. VDT [Internet]. 9 de agosto de 2013 [citado 15 de julio de 2023];3:35-46. Disponible en: https://www.dovepress.com/current-research-and-clinical-trials-for-a-vaccine-against-chikungunya-peer-reviewed-fulltext-article-VDT
(8) Calvo EP, Archila ED, López, Lady, Castellanos JE, Calvo EP, Archila ED, et al. Reconociendo el virus del chikunguña. Biomédica [Internet]. junio de 2021 [citado 15 de julio de 2023];41(2):353-73. Disponible en: http://www.scielo.org.co/scielo.php?script=sci_abstract&pid=S0120-41572021000200353&lng=en&nrm=iso&tlng=es
(9) Bartholomeeusen K, Daniel M, LaBeaud DA, Gasque P, Peeling RW, Stephenson KE, et al. Chikungunya fever. Nat Rev Dis Primers [Internet]. 6 de abril de 2023 [citado 15 de julio de 2023];9(1):1-21. Disponible en: https://www.nature.com/articles/s41572-023-00429-2
(10) Hernández-Valverde A, Porras O. Artritis crónica en una paciente pediátrica posterior a Chikungunya. Acta Médica Costarricense [Internet]. septiembre de 2020 [citado 11 de junio de 2023];62(3):152-5. Disponible en: http://www.scielo.sa.cr/scielo.php?script=sci_abstract&pid=S0001-60022020000300152&lng=en&nrm=iso&tlng=es
(11) O’Sullivan O, Campbell T, Darby A, Mourillon N, Campbell J, Melbourne T, et al. Chikungunya virus infection-associated arthralgia in adult jamaicans post-outbreak. West Indian Med J [Internet]. 18 de octubre de 2018 [citado 11 de junio de 2023];190-6. Disponible en: https://www.mona.uwi.edu/fms/wimj/article/3762
(12) Kantor IN. Dengue, zika, chikungunya y el desarrollo de vacunas. Medicina (Buenos Aires) [Internet]. febrero de 2018 [citado 11 de junio de 2023];78(1):23-8. Disponible en: http://www.scielo.org.ar/scielo.php?script=sci_abstract&pid=S0025-76802018000100005&lng=es&nrm=iso&tlng=es
(13) Santos LLM, de Aquino EC, Fernandes SM, Ternes YMF, Feres VC de R. Dengue, chikungunya, and Zika virus infections in Latin America and the Caribbean: a systematic review. Rev Panam Salud Publica [Internet]. 3 de marzo de 2023 [citado 15 de julio de 2023];47:e34. Disponible en: https://www.scielosp.org/article/rpsp/2023.v47/e34/en/#
(14) Godaert L, Nicolon C, Najioullah F, Kanagaratnam L, Césaire R, Dramé M. ¿Is chikungunya virus infection an independent risk factor for 2-year mortality in older afro-caribbean subjects? IDR [Internet]. 10 de julio de 2020 [citado 15 de julio de 2023];13:2223-8. Disponible en: https://www.dovepress.com/is-chikungunya-virus-infection-an-independent-risk-factor-for-2-year-m-peer-reviewed-fulltext-article-IDR
(15) Arbovirosis | dgvs [Internet]. [citado 11 de junio de 2023]. Disponible en: https://dgvs.mspbs.gov.py/sala_situaciones_arbovirosis_v2/
(16) Amaral JK, Bilsborrow JB, Schoen RT. Chronic chikungunya arthritis and rheumatoid arthritis: what they have in common. Am J Med. marzo de 2020;133(3):e91-7.
(17) Córdova-Pluma VH, Vega-López CA, Alarcón-Sotelo A, Salinas-Lezama E, Córdova-Pluma VH, Vega-López CA, et al. Enfermedad de chikunguña. Medicina interna de México [Internet]. junio de 2018 [citado 20 de julio de 2023];34(3):497-505. Disponible en: http://www.scielo.org.mx/scielo.php?script=sci_abstract&pid=S0186-48662018000300018&lng=es&nrm=iso&tlng=es
(18) Tiwari V, Bergman MJ. Viral arthritis. En: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 [citado 16 de julio de 2023]. Disponible en: http://www.ncbi.nlm.nih.gov/books/NBK531507/
(19) Rodrigo C, Herath T, Wickramarachchi U, Fernando D, Rajapakse S. Treatment of chikungunya-associated joint pain: a systematic review of controlled clinical trials. Trans R Soc Trop Med Hyg. 2 de octubre de 2022;116(10):889-99.
(20) Adarsh MB, Sharma SK, Dwivedi P, Singh MP, Dhir V, Jain S. Methotrexate in early chikungunya arthritis: a 6 month randomized controlled open-label trial. Current Rheumatology Reviews [Internet]. [citado 15 de julio de 2023];16(4):319-23. Disponible en: https://www.eurekaselect.com/article/101010
(21) Trawinski H, Krasselt M, Lübbert C. Chronische chikungunya-arthritis. Z Rheumatol [Internet]. 1 de junio de 2020 [citado 15 de julio de 2023];79(5):470-4. Disponible en: https://doi.org/10.1007/s00393-020-00793-4
(22) Webb E, Michelen M, Rigby I, Dagens A, Dahmash D, Cheng V, et al. An evaluation of global Chikungunya clinical management guidelines: A systematic review. EClinicalMedicine. diciembre de 2022;54:101672.
(23) Bedoui Y, Giry C, Jaffar-Bandjee MC, Selambarom J, Guiraud P, Gasque P. Immunomodulatory drug methotrexate used to treat patients with chronic inflammatory rheumatisms post-chikungunya does not impair the synovial antiviral and bone repair responses. PLoS Negl Trop Dis. agosto de 2018;12(8):e0006634.
(24) Ranzolin A, Marques CDL, da Rocha Junior LF, Duarte ALBP, de Lima HD, de Almeida Martins LM, et al. Treatment with biological therapy is associated with faster recovery and lower frequency of treatment switch among rheumatic patients with Chikungunya fever. Advances in Rheumatology [Internet]. 14 de noviembre de 2022 [citado 16 de julio de 2023];62(1):44. Disponible en: https://doi.org/10.1186/s42358-022-00273-0
(25) Nogueira IA, Cordeiro RA, Henn GA de L, Oliveira JL de. Hydroxychloroquine for the management of chronic chikungunya arthritis. Rev Inst Med Trop Sao Paulo. 2023;65:e26.
(26) Sengupta S, Tripathi A. Evaluation of analgesic and prophylactic activity of curcumin against chikungunya-infected acute/chronic arthralgic mice. J Med Virol. marzo de 2023;95(3):e28661.
(27) Dobbs JE, Tritsch SR, Encinales L, Cadena A, Suchowiecki K, Simon G, et al. Regulatory T-cells and GARP expression are decreased in exercise-associated chikungunya viral arthritis flares. Front Immunol. 2022;13:1007106.
Copyright (c) 2023 Erika Belén Castillo Ocampos, Carlos Rubén Perdomo Paredes, Amanda Gabriel Roa Colman, Ramón Abundio Silva Jara, Bruno Marcelo Ortellado Garrido, Myrian Monserratt Grance Meza, Luz María Cabrera Yudis, María Eugenia Acosta de Hetter, Laura Aria Zayas
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