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Abstract Number: 1319

Chikungunya Fever  in Patients on Biological and on Conventional Dmards  Therapy – Results from the Brazilian Register Biobadabrasil

Aline Ranzolin1, Angela Duarte2, Claudia Marques3, Laurindo Rocha Jr4, Samia Araujo de Souza Studart5, José Caetano Macieira6, Monica Valeria Siqueira S de Vechi6, Lina Oliveira de Carvalho6, Ines Guimarães da Silveira7, Ieda Maria Magalhães Laurindo8 and BiobadaBrasil, 1Rheumatology, Instituto de Medicina Integral Professor Fernando Figueira, Recife, Brazil, 2Internal Medicine, Hospital das Clínicas - UFPE, Recife, Brazil, 3Hospital das Clínicas, Universidade Federal de Pernambuco, Recife - PE, Brazil, 4Rheumatology, Instituto de Medicina Integral Professor Fernando Figueira - IMIP, Recife, Brazil, 5Reumatologia, Hospital Geral de Fortaleza, Fortaleza, Brazil, 6Reumatologia, Hospital Federal de Sergipe, Aracaju, Brazil, 7Reumatologia, Pontificia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil, 8Internal Medicine - Rheumatology, Faculdade de Medicina da Universidade Nove de Julho, São Paulo, Brazil

Meeting: 2016 ACR/ARHP Annual Meeting

Date of first publication: September 28, 2016

Keywords: Biologic agents, rheumatic disease and viruses

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Session Information

Date: Monday, November 14, 2016

Title: Infection-related Rheumatic Disease - Poster

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

 

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.

 symptoms fever Joint pain polyarticular Swollen Exanthema paresthesia CE Daily dose(mg)
cDMARds   n=17 (%)

17 (100)

17 (100)

14 (82)

13 (76)

13*  (54)

9* (53)

12 (61)

16.8 (±5.8)

boDMARDs (n=13) %

13 (100)

13 (100)

11 (85)

10  (77)

7      (76)

2 (15)

8 (71)

16.2 (±6.9)

 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.  


Disclosure: A. Ranzolin, None; A. Duarte, None; C. Marques, None; L. Rocha Jr, None; S. Araujo de Souza Studart, None; J. C. Macieira, None; M. V. Siqueira S de Vechi, None; L. Oliveira de Carvalho, None; I. Guimarães da Silveira, None; I. M. M. Laurindo, None.

To cite this abstract in AMA style:

Ranzolin A, Duarte A, Marques C, Rocha Jr L, Araujo de Souza Studart S, Macieira JC, Siqueira S de Vechi MV, Oliveira de Carvalho L, Guimarães da Silveira I, Laurindo IMM. Chikungunya Fever  in Patients on Biological and on Conventional Dmards  Therapy – Results from the Brazilian Register Biobadabrasil [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/chikungunya-fever-in-patients-on-biological-and-on-conventional-dmards-therapy-results-from-the-brazilian-register-biobadabrasil/. Accessed .
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