Comparison of steroids to nsaids, and other forms of analgesia in the management of post-chikungunya arthritis

Objective: To compare steroids with other treatment options like NSAIDS and other analgesics for management of post-chikungunya arthritis based on visual analogue scale (VAS). Study Design: Comparative cross-sectional study. Place and Duration of Study: Department of Rheumatology, Liaquat National Hospital, Karachi, from Jan to Jul 2018. Methodology: A total of 112 patients were included in this study, of both genders. Patients with history of fever >38.5°C and polyarthralgia who had positive chikungunya IgM serology or PCR were included in this study. Patients fulfilling inclusion criteria and who were treatment naïve were given NSAIDs or other analgesics if contraindication to NSAIDs was present. Those who had received 2 weeks of NSAIDs were given a single dose of intramuscular steroids. Response to treatment was characterized by clinical examination according to visual analogue scale (VAS) taken at baseline, 2 weeks and 4 weeks. All analyses will be conducted by using SPSS-20. Results: Overall, 66 (58.9%) received steroids, 37 (33%) patients were given NSAIDs, and other forms of analgesics were prescribed to 9 (8%) patients. In nearly half of the patients, i.e. 57 (50.89%) partial response was seen, 13 (11.6%) showed complete response, while 42 (37.5%) had persistent arthralgia, which was statistically significant p-value <0.001. Conclusion: This study shows that improvement in symptoms is seen with a single dose of intra-muscular steroid and it helped bring down the VAS score.