Doctors have had few options to treat the chronic rheumatoid arthritis-like symptoms associated with chikungunya virus infections beyond over-the-counter pain relievers. A recent study in Science Translational Medicine has spurred new optimism by finding that a combination therapy—the anti-rheumatic drug abatacept paired with a chikungunya-neutralizing monoclonal antibody—abolished acute symptoms in infected mice.1
The strategy must clear multiple hurdles before it can become a viable intervention in human patients. Mark Heise, PhD, a geneticist who studies viral pathogenesis at the University of North Carolina in Chapel Hill, cautions that the course of a chikungunya infection differs between humans and mice, the latter of which aren’t natural hosts for the virus. Even so, Dr. Heise, who wasn’t involved with the new study but previously collaborated with one of its co-authors, calls it “an important advance” for the field. “I think it’s a really good stepping off point for thinking about these sort of combination therapies,” he says, “especially for people who may be at risk for developing chronic disease manifestations.”
Mosquito-borne chikungunya, which debuted in the Western Hemisphere in late 2013, has since sickened more than 1.8 million people in the Americas. Apart from a few cases in southern Florida, however, the thousands of chikungunya infections seen in the U.S. to date have all been acquired outside the country.