Autor(es): Chopra Arvind, Saluja Manjit, Venugopalan Anuradha

Resumo: To evaluate whether chloroquine (CQ) is more effective than meloxicam for treating early musculoskeletal pain - arthritis following acute chikungunya (CHIK) virus infection. 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 - arthritis were r-omized into a 24-week, 2-arm, parallel efficacy trial of CQ (250 mg/day) - meloxicam (7.5 mg/day). Assessors completed a rheumatology evaluation in a blinded manner - 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, - 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 r-omized to receive CQ - 32 patients r-omized to receive meloxicam) were well matched. There were no significant efficacy differences between the meloxicam group - the CQ group (mean changes in the visual analog scale score for pain -3.9 - -4.2, respectively). Patients improved significantly. Cytokine levels remained several-fold increased, were disproportionate to the clinical response, - were not different from those in the low pain cohort. Seven patients withdrew. Adverse events were mild - infrequent. This exploratory community intervention trial failed to identify an advantage of CQ over meloxicam to treat early musculoskeletal pain - arthritis following acute CHIK virus infection, but therapeutic efficacy of CQ was not ruled out. The inflammatory cytokine response was intense - was not consistent with clinical status.

Imprenta: Arthritis & Rheumatology, v. 66, n. 2, p. 319-326, 2014

Identificador do objeto digital: 10.1002/art.38221

Descritores: Chikungunya virus - Pathogenesis ; Chikungunya virus - Proteins ; Chikungunya virus - Cytokines ; Chikungunya virus - Viral infections ; Chikungunya virus - Clinical examination ; Chikungunya Virus - Virus ; Chikungunya virus - Chikungunya fever ; Chikungunya virus - Epidemic ; Chikungunya virus - Public health

Data de publicação: 2014

INDICADORES

ACESSO