{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T00:14:58Z","timestamp":1792800898114,"version":"4.5.0"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Chronic chikungunya arthritis is a debilitating post-viral inflammatory condition that clinically mimics rheumatoid arthritis and often requires long-term treatment with disease-modifying antirheumatic drugs. Treatment options are limited when conventional synthetic disease-modifying antirheumatic drugs are not tolerated or lose efficacy. We report the case of a 50-year-old Brazilian woman with serologically confirmed chikungunya virus infection who developed chronic chikungunya arthritis with a rheumatoid arthritis\u2013like phenotype. Following an acute febrile illness accompanied by rash and negative dengue serology, she was initially managed with symptomatic analgesics, followed by prednisone and hydroxychloroquine. Despite this treatment, the disease activity score in 28 joints calculated with C-reactive protein was elevated at 6.78. Methotrexate was introduced but was discontinued after 3 weeks due to drug-induced pneumonitis. She later failed leflunomide therapy after 12\u00a0months, with a score of 4.33. Baricitinib (4\u00a0mg\/day), a Janus kinase 1 and 2 inhibitor, was then initiated, resulting in marked clinical and laboratory improvement: the disease activity score decreased to 1.90 over 1 year, C-reactive protein normalised, the erythrocyte sedimentation rate declined progressively, and morning stiffness resolved, with no infectious complications. This case suggests that Janus kinase inhibition may be a therapeutic option for selected patients with chronic chikungunya arthritis refractory to conventional treatment.<\/jats:p>","DOI":"10.1093\/mrcr\/rxag098","type":"journal-article","created":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T11:39:49Z","timestamp":1791027589000},"source":"Crossref","is-referenced-by-count":1,"title":["Successful use of a Janus-kinase (JAK) inhibitor in chronic chikungunya arthritis refractory to conventional synthetic DMARDs: A case report"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8912-1121","authenticated-orcid":false,"given":"Jobson Lopes","family":"de Oliveira","sequence":"first","affiliation":[{"name":"Departamento de Cl\u00ednica M\u00e9dica, Faculdade de Medicina, Universidade Christus (Unichristus) , Fortaleza, Cear\u00e1 ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Kennedy","family":"Amaral","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Ci\u00eancias da Sa\u00fade, Faculdade de Medicina, Universidade Federal do Cariri , Barbalha, Cear\u00e1 ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Igor Albuquerque","family":"Nogueira","sequence":"additional","affiliation":[{"name":"Departamento de Cl\u00ednica M\u00e9dica, Hospital das Cl\u00ednicas da Faculdade de Medicina de Ribeir\u00e3o Preto, Universidade de S\u00e3o Paulo , Ribeir\u00e3o Preto, S\u00e3o Paulo ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis Arthur Brasil Gadelha","family":"Farias","sequence":"additional","affiliation":[{"name":"Departamento de Cl\u00ednica M\u00e9dica, Faculdade de Medicina, Universidade Christus (Unichristus) , Fortaleza, Cear\u00e1 ,","place":["Brazil"]},{"name":"Departamento de Doen\u00e7as Infecciosas do Hospital das Cl\u00ednicas, Laborat\u00f3rio de Investiga\u00e7\u00e3o M\u00e9dica, Universidade de S\u00e3o Paulo , S\u00e3o Paulo, SP ,","place":["Brazil"]},{"name":"Departamento de Infectologia, Hospital S\u00e3o Jos\u00e9 de Doen\u00e7as Infecciosas , Fortaleza, CE ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert T","family":"Schoen","sequence":"additional","affiliation":[{"name":"Section of Rheumatology, Allergy, and Immunology, Yale University School of Medicine , New Haven, CT ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"key":"2026102111513659500_ref1","doi-asserted-by":"crossref","DOI":"10.1016\/j.tmaid.2021.102168","article-title":"Chikungunya and arthritis: an overview","volume":"44","author":"Kumar","year":"2021","journal-title":"Travel Med Infect 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