LAUSR

Background Chikungunya Fever (CHIK) may evolve chronically with joint impairment, often disabling, which leads to a functional and quality of life impact. The CHIK outbreak in Brazil began in 2015, reaching its peak in 2016, particularly in the Northeast of the country, with 2 35 136 reported cases. Since this is the first epidemic of CHIK in Brazil, data on persistent post-acute joint disease are scarce, and this knowledge is of fundamental importance in defining the long-term impact of the disease. Objectives To evaluate factors associated with persistence of the joint symptoms in CHIK patients. Methods The CHIKBRASIL cohort is a prospective, multicenter, observational study, conducted in six research rheumatology centres from the Northeast of Brazil, and has enrolled CHIK patients with joint manifestations since April 2016.1 Data from 207 patients followed up to December 2017 were analysed. Results The mean age was 54.7 years, most female (90.3%); 39.1% of the patients had a diagnosis of previous rheumatic disease (49.4% osteoarthritis). The most frequent initial clinical manifestations were arthralgia (98.1%), fever (95.6%), morning stiffness (92.3%) and arthritis (88.9%). The first evaluation with the rheumatologist occurred at a median time of 12 weeks after the onset of symptoms; at this time the median PGA of disease by the patient was 7 and by the physician was 6; the median number of painful joints was 8 and of swollen joints was 3% and 75.5% of the patients had arthritis. After a median follow-up time of 37 weeks, there was complete improvement of joint symptoms in 21.7% and 18.9% of cases reported little or no improvement. The persistence of arthralgia was reported by 76.7% and arthritis by 28.1% of the patients. A significant association was found between the persistence of arthritis and the physician’s general VAS (p=0.02), number of painful (p=0.002) and swollen (p=0.001) joints, besides knees (p=0,009), proximal interphalangeal (p=0,07), metacarpophalangeal (p=0,022), elbow (p=0,026) and wrist oedema (p=0,003) at the first consultation). With regard to the persistence of joint pain, associations were found with a higher initial morning stiffness time (p=0.011), shoulder tendinopathy (p=0.019) and tarsal pain. The factors associated with no complete improvement after the follow-up period were tarsal pain (0,021) and shoulder tendinopathy. Conclusions In the Brazilian CHIK patients, the percentage of persistence of joint manifestations is high after 24 weeks, with a considerable number of patients maintaining arthritis, similar to other countries in Latin America.2 Significant associated factors were more severe initial symptoms, polyarthritis, polyarthralgia, shoulder tendinopathy and tarsal pain. References [1] Marques CDL, Cavalcanti N, Luna M, et al. Arthritis Rheumatol [Internet]201620-nov-2016;68(S10). [2] Chang AY, Encinales L, Porras A, et al. Arthritis Rheumatol 20172017Dec 20. doi:10.1002/art.40384 Disclosure of Interest None declared