Among 159 patients included, 122 suffered from de novo RSMKD with 28 presenting chronic pains and 94 fulfilling CIR criteria. RA accounted for 40/92 (12 positive for anti-CCP antibodies); SA for 33/94 (15 with psoriasis); and distal UP for 21/94. 72 of them (including the 31 CIR with joint damages) were treated with MTX (40 RA, 26 SA), reaching efficacy in 54 cases (30 RA, 19 SA, 5 UP) versus failure in 18 cases (10 RA, 7 SA, 1 UP). No severe side event was observed. The group efficacy did not differ with age, sex or type of CIR, but was significantly associated with the early introduction of MTX within the first year of CIR progression (p =0,034). Among the wide spectrum of post CHIK RMSKD, CIR should benefit from the early use of MTX. DMARD’s efficacy could bring some clues to investigate the underlying post CHIK-infection disorders.
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Javelle et al. (2014) studied this question.