Recomendações da Sociedade Brasileira de Reumatologia para diagnóstico e tratamento da febre chikungunya. Parte 2 – Tratamento

Marques, Cláudia Diniz Lopes; Duarte, Ângela Luzia Branco Pinto; Ranzolin, Aline; Dantas, Andréa Tavares; Cavalcanti, Nara Gualberto; Gonçalves, Rafaela Silva Guimarães; Rocha, Laurindo Ferreira da; Valadares, Lilian David de Azevêdo; Melo, Ana Karla Guedes de; Freire, Eutília Andrade Medeiros; Teixeira, Roberto; Neto, Francisco Alves Bezerra; Medeiros, Marta Maria das Chagas; Carvalho, Jozélio Freire de; Santos, Miguel Ángel; Océa, Regina Adalva de Lucena Couto; Levy, Roger A.; Andrade, Carlos Augusto Ferreira de; Pinheiro, Geraldo da Rocha Castelar; Abreu, Mirhelen Mendes de; Verztman, José Fernando; Merenlender, Selma; Ribeiro, Sandra Lúcia Euzébio; Costa, Izaías Pereira da; Pileggi, Gecilmara Salviato; Trevisani, Virgínia Fernandes Moça; Lopes, Max Igor Banks Ferreira; Brito, Carlos; Figueiredo, Eduardo Henrique Lopes; Queiroga, Fábio Martins de; Feitosa, Tiago; Tenório, Angélica da Silva; Siqueira, Gisela Rocha de; Paiva, Renata; Vasconcelos, José Tupinambá Sousa; Christopoulos, Georges Basile

doi:10.1016/j.rbr.2017.05.005

Cited by 43 publications

(24 citation statements)

References 37 publications

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“…In its recommendations for the treatment of CHIK, the BSR suggests the administration of methotrexate in the chronic phase of the disease or (considering withdrawal difficulty from this corticosteroid) the administration of a nonsteroidal antiinflammatory drug for the treatment of musculoskeletal pain refractory to analgesics 20 . In the present study, majority of the patients were not taking any medication despite experiencing pain, which may be related to the lack of medical follow-up with a skilled professional for the treatment of this illness.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of functional disability after Chikungunya infection

Panato¹,

Figueredo²,

Bassi³

et al. 2019

Rev. Soc. Bras. Med. Trop.

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Introduction: Chikungunya (CHIK) is caused by the Chikungunya virus, which is an Alphavirus of the Family Togaviridae transmitted to humans through female mosquitoes of the genus Aedes. Methods: A cross-sectional study was conducted involving the administration of a questionnaire addressing sociodemographic and health variables and the Roland-Morris Disability Questionnaire on general pain to patients with CHIK in the City of Imperatriz, Brazil, between January and December 2017. Results: Data of a total of 130 patients were evaluated. The mean age was 52 years (standard deviation=13.3); majority of the patients were female (n=120) with a prevalence of 38.0% for functional disability. Statistical differences were noted for marital status (p=0.037), presence/absence of comorbidities (p=0.050), and the use of medications prior to the diagnosis of CHIK (p=0.050), use of methotrexate (p=0.030), use of nonsteroidal anti-inflammatory drugs (p≤0.035), and use of nonhormonal antiinflammatory drugs (p=0.001). Conclusions: Patients in the chronic phase of CHIK present functional disability, thus alerting healthcare professionals to the importance of implementing actions aimed at an adequate treatment in all phases of the disease, mainly related to pain treatment and motor rehabilitation.

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Section: Discussionmentioning

confidence: 99%

Evaluation of functional disability after Chikungunya infection

Panato¹,

Figueredo²,

Bassi³

et al. 2019

Rev. Soc. Bras. Med. Trop.

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“…The Brazilian Ministry of Health's recommendations were not used because, in addition to the maximum dose being very high (40 mg), the study carried out by the Brazilian Society of Rheumatology did not show benefits in doses above 20 mg. The Ministry of Health places a maximum treatment time of 21 days with a gradual dose reduction, disregarding the reduction of symptoms, clinical improvement, and options in case of a therapeutic failure within the specified time [4].…”

Section: Discussionmentioning

confidence: 99%

“…In cases of pain resurgence during corticosteroid reduction, a 2.5 mg reduction was performed every 7 days. For patients who had more than 3 months of symptoms (chronic), what is recommended by the Brazilian Society of Rheumatology followed, use of methotrexate started at the minimum initial dose of 10 mg per week, with reevaluation of treatment being done every four weeks, with the gradual increase in a dose up to a maximum of 25 mg per week in case of partial response [4].…”

Section: Methodsmentioning

confidence: 99%

“…After the infected mosquito bite, the incubation period lasts on average 3 to 7 days (range: 1 -12 days), followed by fever associated with arthralgia/arthritis (87%), low back pain (67%), and headache (62%). Viremia persists up to 8 days after the onset of clinical symptoms and may disappear after acute symptoms, with a resolution of the condition [4]. Some patients may have relapsed rheumatological symptoms (for example, polyarthralgia, polyarthritis, and tenosynovitis) in the months following the acute disease, thus progressing to a subacute phase of the disease that lasts up to three months [5].…”

Section: Introductionmentioning

confidence: 99%

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Drug Therapeutic in the Subacute and Chronic Phase of Chikungunya Virus Infection

Silva¹,

Sousa²,

Caldas³

2021

OJRA

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Background: Chikungunya fever is an infectious disease that can evolve to a subacute or chronic condition, with changes in the daily activities of patients. Drugs that aim to reduce these symptoms are used, such as corticoids (acute phase) and disease-modifying anti-rheumatic drugs (chronic phase). Objective: To evaluate the clinical response to drug therapy in the subacute and chronic phase of infection by the Chikungunya virus. Methodology: A prospective and a retrospective study with patients with subacute and chronic Chikungunya infection, out at the infection and autoimmunity outpatient clinic at the Nucleus of Tropical Medicine, from January 2016 to December 2019, in the morning of Thursdays. The patient was observed in the Baseline, first and second return, and drugs were introduced according to the stage of the disease with subsequent reassessment. The Visual Analogue Scale (VAS) was applied to all evaluation moments. Results: 101 patients were evaluated, and arthralgia was the predominant symptom in the three evaluated moments. According to the VAS, moderate baseline pain was observed in 58.1% and 58.6% of subacute and chronic cases, respectively. On the first return, moderate pain still predominated in 46.2% in subacute cases and 43% in chronic cases. In the second visit, all patients were in the chronic phase of the disease, 43.8% had VAS with no pain. Regarding the number of compromised joints in the Baseline, polyarticular involvement predominated in both subacute (79%) and chronic (74.1%) cases, in the first return, oligoarticular involvement predominated in 53.8% of subacute cases and 54.7% in chronic cases and, the second return, 40.6% of the patients had oligoarticular involvement and 43.8% had no joint involvement. As for the use of medications in the Baseline, 33.4% of subacute cases used antiinflammatory drugs, and 40% of chronic cases used corticosteroids. At the first visit, 25% of chronic patients were already using combined corticosteroids and methotrexate and

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“…Clinicamente, a febre Chikungunya, apresenta-se na fase aguda pacientes sintomáticos geralmente com inicio abrupto da doença caracterizada por caracterizada por febre alta, poliartralgia, dores nas costas, dor de cabeça e fadiga. Na fase tardia as principais queixas são: dores severas nas articulações dos tornozelos, punhos, cotovelos e ombros, ou seja, artralgia ou dores músculo-esqueléticas com sinais mais longos, perdurando por semanas ou meses, e às vezes por anos (KOHLER et al,2018;MARQUES et al, 2017& RIBEIRO et al, 2016.Outros parâmetros como a gravidade da dor articular e a presença de edemas nas articulações se correlacionam com a cronicidade dos sintomas (SALES et al 2018).…”

Section: Categoria 1: Comprometimento Articularunclassified