Tab Application Banner
  • Users Online: 757
  • Home
  • Print this page
  • Email this page
Home About us Editorial board Ahead of print Current issue Search Archives Submit article Instructions Subscribe Contacts Login 
ORIGINAL ARTICLE
Year : 2008  |  Volume : 3  |  Issue : 3  |  Page : 93-97

Methotrexate and hydroxychloroquine combination therapy in chronic chikungunya arthritis: a 16 week study


Vedanta Institute of Medical Sciences, Ahmedabad, India

Correspondence Address:
s Pandya
Vedanta Institute of Medical Sciences, Ahmedabad
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


Rights and PermissionsRights and Permissions

Objective: To study the clinical profile of patients of chronic chikungunya arthritis presenting to a rheumatology OPD in the Western part of India and to judge the treatment response to the disease modifying drugs (methotrexate and hydroxychloroquine) used to treat them. Materials and methods: The diagnosis of chronic chikungunya arthritis was based on clinical criteria only. All patients giving a history of fever with arthritis starting during the epidemic of chikungunya in the Western part of India (August-September 2006) and having had the arthritis for > 3 months since then were included in the study. Baseline clinical characteristics were calculated. Most patients received methotrexate (15 to 20 mg weekly) and hydroxychloroquine for their chronic arthritis and their ACR 20, 50 and 70 responses and EULAR remission and EULAR good response based on DAS 28 ESR were calculated. Results: A total of 305 patients presented to the OPD till March 2008. Mean age of the patients was 49 years. Female to male ratio was 2.8:1 (223:82). The other mean baseline values were: patients global 6 (0 to 10, 0 best), physician's global 5.8 (0 to 10, 0 best), HAQ score 1.6 (0 to 3), swollen joint count 8.8 (28 joint count), tender joint count 14 (28 joint count), ESR 52 mm first hour (Westergren). About one-third of the patients had parasthesias in the carpal tunnel distribution. Rheumatoid factor was positive in 76 out of 256 when it was done (29.7%) and anti-CCP was positive in 6/73 when it was done. Data needed for judging treatment response was available in 149 patients at a mean follow up of 16 weeks period and they received combination of methotrexate and hydroxychloroquine. ACR 20 was achieved in 73/149 (48.9%), ACR 50 in 28/149 (18.8%) and ACR 70 in 6/149 (4%). Only one of the patients achieved EULAR remission (DAS 28 ESR < 2.6) and four others achieved EULAR good response (DAS 28 ESR < 3.2) at the end of 16 weeks. None of the patients had any adverse effect to the DMARDs used. Conclusion: Chronic chikungunya arthritis is a significant cause of morbidity in this part of the world. In this analysis most patients were middle aged and female to male ratio was 3:1. About one-third of the patients reported carpal tunnel symptoms. About half of the patients who received the combination of methotrexate and hydroxychloroquine achieved an ACR 20 response at 16 weeks.


[PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed207    
    Printed8    
    Emailed0    
    PDF Downloaded103    
    Comments [Add]    

Recommend this journal