F. Rosso et al., 2018 [31]ColombiaColombianCase Report and Literature ReviewNot mentionedCorticosteroids in the management of inflammatory arthritis Patients in this study underwent organ transplantation. Some of them developed leucopenia, neutropenia, and thrombocytopenia, and all of them developed lymphopenia. None developed graft rejection or died in process.E. Bouquillard et al., 2017 [24]FranceFrenchOriginal articleSerological test and clinical symptomsAfter the acute phase, joint pain is well-controlled with analgesics and NSAIDs; corticotherapy may be effective at moderate doses; and Chloroquine salt are sometimes prescribed, particularly in the case of chronic joints that are non-responsive to analgesics and NSAIDs. Chronic joint pain was associated with synovitis of the patients, affecting primarily the wrists, the proximal interphalangeal joints of the fingers, and the ankles. Attempts to detect the viral genome in joint fluid and synovial tissue using the RT-PCR technique were repeatedly unsuccessful.Ravindran et al., 2016 [32]IndiaIndianOriginal articleClinical symptoms and serological testDMARD combination to Chikungunya arthritis (CA); triple combination with methotrexate, sulfasalazine, and hydroxychloroquine; monotherapy with hydroxychloroquineTreatment with combination therapy leads to substantial improvement and reduces disability and pain in CA; levels of cytokines such as interleukin (IL)-6, IL-8 IL-13, and TNF; (MCP)-1; and (MIP)-1 also appear to play important roles in the pathogenesis of CA. Triple therapy is superior than monotherapy.M. Blettery et al., 2019 [22]FranceFrenchOriginal articleSerological tests or PCR, then joints imaging studies by Doppler ultrasonography (DUS)Not mentionedDUS of painful joints revealed effusions in 92.8%of them (unilateral). Subcutaneous inflammatory infiltrations of the ankles were revealed at 29% of patients. Bone erosion was not observed.A. Ribeiro et al., 2016 [25] BrazilBrazilianCase ReportsClinical symptoms.Anti-inflammatory and analgesics drugs; in parallel, for local joints, applications include continuous ultrasound, infrared laser, and TENS-burstThe association of ultrasound, infrared laser, and TENS may accelerate the healing process by collaborating in different ways in cell recovery, speed of nerve conductions and collagen production, and extensibility. It could reduce inflammation, pain, and joints stiffness.M.H. Pouriayevali, et al., 2019 [23]IranIranianOriginal articleSerological test (ELISA and PCR tests) and clinical symptomsNot mentioned Correlation between abroad travel history and CHIKV infection; also, Iran-5300 strain showed a rare non-synonymous substitution T/C at nucleotide 10,560.Y. Bedoui et al., 2021 [18]FranceFrenchOriginal articleSerological test, RT-PCR, immunohistochemistry, cytotoxicity assaysMethotrexate and dexamethasonePIC and CHIKV enhanced mRNA expression of COX-2; PIC increased the mRNA levels of cPLA2α and of mPGES-1, two other central enzymes in PGE2 production; IFNβ upregulated cPLA2α and COX-2 transcription levels; MTX failed to control the expression of all these enzymes, but dexamethasone was able to control the capacity of pro-inflammatory cytokines.M. Agrawal et al., 2019 [33]IndiaIndianOriginal articleNot applicableNot applicableThe modulation of AKT3 induces the TNF-α-mediated autophagy and cytokine secretion. Additionally, AKT3 has been reported to act via PI3K/AKT/mTOR pathway, which activates the antiapoptotic genes and sensitizes the fibroblasts to TNF-α and TRAIL-mediated apoptosis. Therefore, during CHIKV infection, suppression of the robust inflammatory response may be regulated by the induction of hsa-miR-4717-3p through AKT3 gene target. J. J. Hoarau et al., 2010 [34]FranceFrenchOriginal articleRT-PCR, Mac-ELISA, Clinical examinations and biological symptoms; PFU evaluation, immunochemistry and Western blot analysis MethotrexateCHIKV (mRNA and proteins) persisting in synovial macrophages could contribute to tissue injuries, apoptosis in vitro, fibrosis, and a polarized inflammatory response reminiscent of rheumatoid arthritis. The expression of immunoregulatory cytokines, such as IL-10 and TGF-β1, was demonstrated at T0 (time 0, considered before symptoms appearance) and M6 (Month 6). M.d.R.Q. Lima et al., 2021 [35]BrazilBrazilianOriginal articleMac-ELISA, RT-PCRNot mentionedThe Euroimmun anti-CHIKV IgM ELISA test showed 100% sensitivity and 25.3% specificity due to cross reactivities observed with dengue. IgM positive and acute cases of dengue, the assay showed cross-reactivity of 46.7% and 31.6%, respectively, and so, molecular tests, such as RT-PCR, was used as an option to confirm cross-reactivity or not.