On Chikungunya Acute Infection and Chloroquine Treatment

Lamballerie, Xavier De; Boisson, Véronique; Reynier, Jean-Pierre; Enault, Sébastien; Charrel, Rémi N.; Flahault, Antoine; Roques, Pierre; Grand, Roger Le

doi:10.1089/vbz.2008.0049

Cited by 212 publications

(188 citation statements)

References 10 publications

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“…EFFECTIVENESS OF CHLOROQUINE FOR POST-CHIK MUSCULOSKELETAL DISORDERSNCT00391313) (14) was terminated prematurely, but the investigators concluded that CQ had no therapeutic efficacy (15). An open-label short-term study demonstrated that hydroxychloroquine offered no additional advantage over a combination of NSAIDs and steroids in the treatment of extended symptoms of acute CHIK virus infection (16).…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Chloroquine and Inflammatory Cytokine Response in Patients With Early Persistent Musculoskeletal Pain and Arthritis Following Chikungunya Virus Infection

Chopra¹,

Saluja²,

Venugopalan³

2014

Arthritis & Rheumatology

119

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Objective. To evaluate whether chloroquine (CQ) is more effective than meloxicam for treating early musculoskeletal pain and arthritis following acute chikungunya (CHIK) virus infection.Methods. During the 2006 CHIK epidemic, 509 rural community cases of acute CHIK virus infection were identified in the district of Sholapur in India. Seventy consenting adult patients (seropositive for IgM/ IgG anti-CHIK antibody) with early persistent musculoskeletal pain and arthritis were randomized into a 24-week, 2-arm, parallel efficacy trial of CQ (250 mg/ day) and meloxicam (7.5 mg/day). Assessors completed a rheumatology evaluation in a blinded manner and collected blood samples in the patients' homes, as per protocol. Laboratory parameters included serum cytokine assay (interleukin-6 [IL-6], interferon-␥ [IFN␥], tumor necrosis factor ␣, CXCL10/IFN␥-inducible protein 10, and IL-13). Twenty-two patients who failed to meet the eligibility criteria (low pain cohort) were also followed up with similar evaluations. An intent-to-treat analysis was completed. At baseline, the 2 groups (38 patients randomized to receive CQ and 32 patients randomized to receive meloxicam) were well matched.Results. There were no significant efficacy differences between the meloxicam group and the CQ group (mean changes in the visual analog scale score for pain ؊3.9 and ؊4.2, respectively). Patients improved significantly. Cytokine levels remained several-fold increased, were disproportionate to the clinical response, and were not different from those in the low pain cohort. Seven patients withdrew. Adverse events were mild and infrequent. Conclusion. This exploratory community intervention trial failed to identify an advantage of CQ over meloxicam to treat early musculoskeletal pain and arthritis following acute CHIK virus infection, but therapeutic efficacy of CQ was not ruled out. The inflammatory cytokine response was intense and was not consistent with clinical status.The 2006 chikungunya (CHIK) virus epidemic originated in East Africa and rapidly spread to the Indian subcontinent (1-3). Unlike previous epidemics, thousands of new cases and patients with persistent musculoskeletal pain and arthritis continue to be reported. We previously observed a wide spectrum of post-CHIK virus musculoskeletal pain and arthritis, but the etiology remains unknown (4). Oral chloroquine (CQ) has been used extensively to treat acute and chronic musculoskeletal pain and arthritis following CHIK virus infection; however, clinical data remain sparse (3).Acute CHIK virus infection is a self-limiting, excruciatingly painful arboviral illness of short duration. In our experience, acute symptoms subsided within 10 days, and approximately two-thirds of patients recovered within 3 weeks (4). Against this background, we carried out a controlled evaluation of CQ to treat patients with early persistent musculoskeletal pain and arthritis following CHIK virus infection. Selected cytokine assays were carried out to study the inflammatory nature of musculoskeletal pain and ar...

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Section: Discussionmentioning

confidence: 99%

Effectiveness of Chloroquine and Inflammatory Cytokine Response in Patients With Early Persistent Musculoskeletal Pain and Arthritis Following Chikungunya Virus Infection

Chopra¹,

Saluja²,

Venugopalan³

2014

Arthritis & Rheumatology

119

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“…Aunque un estudio previo sugería que el fosfato de cloroquina ofrecía algún beneficio, 45 un ensayo clínico aleatorizado, doble ciego y controlado con placebo no encontró un beneficio real para los síntomas articulares con este tratamiento. 46 La artritis periférica incapacitante que tiene tendencia a persistir por meses, si es refractaria a otros agentes, puede ocasionalmente responder a los corticoesteroides a corto plazo. 38 Para limitar el uso de corticoesteroides orales se pueden usar inyecciones locales (intra-articulares) de corticoesteroides o terapia tópica con AINEs.…”

Section: Resumen De La Sección De Laboratoriounclassified

Insecticide Susceptibility of Aedes aegypti L. (Diptera: Culicidae) in Guerrero, Mexico

Chino-Cantor

Sánchez‐Arroyo

Ortega-Arenas

2014

Southwestern Entomologist

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Las solicitudes y las peticiones de información deberán dirigirse a Servicios Editoriales, Área de Gestión de Conocimiento y Comunicación (KMC), Organización Panamericana de la Salud, Washington, D.C., Estados Unidos de América, que tendrá sumo gusto en proporcionar la información más reciente sobre cambios introducidos en la obra, planes de reedición, y reimpresiones y traducciones ya disponibles.©Organización Panamericana de la Salud, 2011. Todos los derechos reservados.Las publicaciones de la Organización Panamericana de la Salud están acogidas a la protección prevista por las disposiciones sobre reproducción de originales del Protocolo 2 de la Convención Universal sobre Derecho de Autor. Reservados todos los derechos.Las denominaciones empleadas en esta publicación y la forma en que aparecen presentados los datos que contiene no implican, por parte de la Secretaría de la Organización Panamericana de la Salud, juicio alguno sobre la condición jurídica de países, territorios, ciudades o zonas, o de sus autoridades, ni respecto del trazado de sus fronteras o límites.La mención de determinadas sociedades mercantiles o de nombres comerciales de ciertos productos no implica que la Organización Panamericana de la Salud los apruebe o recomiende con preferencia a otros análogos. Salvo error u omisión, las denominaciones de productos patentados llevan en las publicaciones de la OPS letra inicial mayúscula. La Organización Panamericana de la Salud ha adoptado todas las precauciones razonables para verificar la información que figura en la presente publicación, no obstante lo cual, el material publicado se distribuye sin garantía de ningún tipo, ni explícita ni implícita. El lector es responsable de la interpretación y el uso que haga de ese material, y en ningún caso la Organización Panamericana de la Salud podrá ser considerada responsable de daño alguno causado por su utilización.

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“…Thus, the study concluded that there was no justification for the use of chloroquine in acute CHIKV infection. 103 However, anti-CHIKV activity of chloroquine was determined in virus yield from Vero cells treated with the drug as compared with untreated infected control cells. The viral titer was observed to be reduced by 99% using nearly 20 µM chloroquine.…”

Section: Treatmentmentioning

confidence: 99%

Current research and clinical trials for a vaccine against Chikungunya virus

Singh¹,

Chhabra²,

Mittal³

et al. 2013

VDT

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Chikungunya infection is a self-limiting Aedes mosquito-borne arboviral disease with variable clinical manifestations, ranging from asymptomatic illness to a very severe and crippling arthralgia. Until recently, Chikungunya was a little known disease that re-emerged in 2005-2006, leading to major outbreaks on the Indian Ocean Islands and in South East Asia, and eventually extending its range to temperate regions. It drew global attention due to its explosive onset, extensive geographic distribution, and high morbidity. Since re-emergence, an estimated one million symptomatic cases with 0.1% fatality per year have been reported globally. A lack of herd immunity, vector control, and globalization and trade are clearly a problem in the spread of this disease. The Chikungunya virus (CHIKV) has also acquired biologically important mutations during its evolution, increasing its geographic reach. This disease has resulted in a loss of productivity in affected communities. The absence of a vaccine or an effective antiviral therapy makes dealing with this disease challenging for those involved in public health. There is an emergent need for an effective vaccine against CHIKV infection. The candidates that have been tested include attenuated living, nonliving and genetically engineered vaccines. Several of these vaccine candidates are in preclinical and clinical trials. This review outlines the current knowledge about chikungunya infection and vaccine development.

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On Chikungunya Acute Infection and Chloroquine Treatment

Cited by 212 publications

References 10 publications

Effectiveness of Chloroquine and Inflammatory Cytokine Response in Patients With Early Persistent Musculoskeletal Pain and Arthritis Following Chikungunya Virus Infection

Effectiveness of Chloroquine and Inflammatory Cytokine Response in Patients With Early Persistent Musculoskeletal Pain and Arthritis Following Chikungunya Virus Infection

Insecticide Susceptibility of Aedes aegypti L. (Diptera: Culicidae) in Guerrero, Mexico

Current research and clinical trials for a vaccine against Chikungunya virus

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