Corticosteroid therapy in an alphaviral arthritis.
BACKGROUND
: Corticosteroid use during acute viral arthritis is considered to be contraindicated as a result of the risk of immunosuppression causing enhanced infection and disease exacerbation.


OBJECTIVE
: The objective of this study was to analyze the effect of oral corticosteroid therapy on symptoms of the viral arthritic disease, Ross River virus disease (RRVD).


METHODS
: Patients with RRVD were enrolled in 2 prospective longitudinal studies. Medications and comorbidities were recorded and the patients' health was assessed using 2 validated quality-of life-questionnaires, the Comparison of Clinical Health Assessment Questionnaire (CLINHAQ) and the Medical Outcomes Study Short Form (SF-36).


RESULTS
: Six patients taking corticosteroids showed no exacerbation of RRVD compared with patients not taking steroids. The CLINHAQ Functional Disability Index also indicated that corticosteroid users recovered faster compared with patients using nonsteroidal antiinflammatory drugs.


CONCLUSIONS
: Conventional concern that corticosteroid treatment will exacerbate disease appears unjustified for alphaviral arthritides once serodiagnosis has demonstrated antiviral immunity.
Mylonas
Andrea D
AD
From the *Australian Centre for International and Tropical Health and Nutrition, Queensland Institute of Medical Research and the University of Queensland, Brisbane, Queensland, Australia; the †Department of Rheumatology, Princess Alexandra Hospital, Brisbane, Queensland, Australia; and the ‡Emergency Department, Prince Charles Hospital, Brisbane, Queensland, Australia.
Harley
David
D
Purdie
David M
DM
Pandeya
Nirmala
N
Vecchio
Philip C
PC
Farmer
J F
JF
Suhrbier
Andreas
A