Background/Purpose:   Chikungunya fever (CHIKF) is a systemic arboviral disease manifesting with fever, acute arthritis and rash. The acute symptoms can last for days but articular pain and edema can persist and chronify. Objectives: to analyze the clinical manifestations of CHIKF in patients with a previous established articular disease in regular biological (boDMARDs) or conventional DMARDs (cDMARDs) treatment included in BiobadaBrasil register,

Methods: an active search for CHIKF in patients with established rheumatic diseases (ACR criteria) in regular follow up in our database and living in the epidemic area (127.8CHIKFcases/100000 habitants – 18 epidemiological week) was performed; positive cases were identified and  submitted to clinical exam and structured interview,

Results: from 358 patients in regular follow up at the 4 centers localized in the epidemic area, CHIKF was diagnosed in  30 (8.4%) patients based on clinical and epidemiological criteria. In this sample, 13 patients  were on boDMARDs therapy (4 on adalimumab, 2 on certolizumab and 3 on etanercept, and one on abatacept, infliximabe, golimumabe and rituximab); median treatment duration 30 months[1-70] )  and 17 on cDMARDs. Nearly all patients (85%) lived in urban area, 87% were female, mean age 46(10)yrs; mean disease duration 8 (1-21).yrs. Regarding diagnosis 22 have RA, 7AS  and 1 SLE. Remarkable symptoms reported in the table below as well CHIKF treatment with corticoid (CE)   *p<0.05.

 Symptons presented by more than 60% of the patients, with no difference between treatment groups were: myalgia, fatigue, GI complains (diarrhea, nausea, vomit, pain), headache, morning stiffness. Presence of exanthema, paresthesia and neuropatic pain were more frequent in cDMARds treated patients. At the moment of the CHIKF symptoms 76% of the patients in both treatment groups were considered in remission and the articular manifestations were reported as similar to the rheumatic disease only by 15% of the patients on boDMARDs and 18% of the ones on cDMARDs. The pain intensity and localization was reported as different of other acute exacerbations of the previous rheumatic disease. So far, the duration of symptoms were similar with just 23% of the patients having less than 3 months of symptoms. There were no serious complications of CHIKF in any of the treatment groups.

Conclusion: :  boDMARDs does not aggravate CHIKF symptoms or persistence. The clinical manifestations of CHIKF in patients with rheumatic diseases are no different from literature reports in health individuals.