To Study Effectiveness of Prednisolone in Debilitating Chikungunya Arthritis in Patients Admitted at a Tertiary Care Hospital in Western Maharashtra

A BSTRACT Background: Chikungunya virus infection often leads to chronic arthritis, significantly impairing patients’ quality of life. This study evaluates the efficacy and safety of two corticosteroid regimens in managing refractory arthritis associated with chikungunya fever. Methods: This retrospective cohort study included 92 patients with post-chikungunya arthritis refractory to NSAIDs and tramadol. Two treatment regimens were utilized: 15-day regimen: prednisolone 10 mg/day for 5 days, followed by a gradual taper over 10 days. High-dose regimen for severe arthritis: prednisolone at 0.5 mg/kg/day until an adequate clinical response (e.g., independent mobility and satisfactory pain control) was achieved. After resolution of joint pain, the dose was maintained for 3–5 days and then tapered by 5 mg/day per week. Prednisolone use did not exceed 4 weeks in this regimen. Eighty-seven patients received the 15-day regimen, while five with severe arthritis, defined as dependence on others for activities of daily living despite NSAIDs and tramadol, were treated with the high-dose regimen. Results: The 15-day regimen effectively relieved joint pain, stiffness, and functional limitations in mild to moderate cases. Patients in the high-dose regimen achieved rapid improvement in pain control and mobility without significant adverse events. Both regimens were well tolerated, with no serious corticosteroid-related complications observed. Conclusion: Tailored corticosteroid regimens provide effective symptom relief in chikungunya-associated arthritis. The 15-day regimen is suitable for mild to moderate cases, while the high-dose regimen is an effective option for severe arthritis. These findings support personalized corticosteroid therapy in post-chikungunya arthritis management.