Chikungunya infection in the general population and in patients with rheumatoid arthritis on biological therapy

Chikungunya infection is a febrile illness, which currently is afflicting the Caribbean islands including the Dominican Republic. We would like to report our experience with Chikungunya-related musculoskeletal manifestations in our arthritis clinics in the Dominican Republic. A total of 514 patients presented for the first time to our arthritis clinic exhibiting musculoskeletal manifestations, 473/514 (92 %) exhibiting symmetric polyarthralgias, 344/514 (67 %) arthritis, and 385 (75 %) skin rash. The great majority 457.46 (89 %) exhibited very good clinical response to nonsteroidal anti-inflammatory drugs (NSAIDs), 370 (72 %) require low-dose steroids, and only 5 patients (0.97 %) required methotrexate therapy. In addition, of a total of 328 patients with rheumatoid arthritis on biological treatment, 53 exhibited Chikungunya-related musculoskeletal manifestations; 51/53 (96.2 %) exhibited symmetric polyarthralgias, 25/53 (47.1 %) arthritis, and 13/53 (24.5 %) tendinopathy. Of most patients, 51/53 responded to NSAIDs, of which, 23 patients only responded partially, and in total 25 (47.1 %) required low-dose steroids. Disease-modifying antirheumatic drug (DMARD) therapy including biologics remained unchanged in this population.