# Methotrexate treatment of Arthritis caused by Chikungunya virus (MARCH): A randomized controlled trial of methotrexate versus placebo in the treatment of chronic arthritis after chikungunya infection

> **NIH NIH R34** · GEORGE WASHINGTON UNIVERSITY · 2020 · $351,997

## Abstract

ABSTRACT
Chikungunya virus (CHIKV) is an alphavirus spread by mosquitos that causes persistent arthritis in
approximately 25% of people two years after initial infection. There is currently no standard evidence-based
treatment for CHIKV chronic arthritis. The French guidelines suggest the use of methotrexate in the treatment of
chronic CHIKV arthritis however there are no randomized placebo-controlled trials of methotrexate to support
this recommendation. Our long-term goal is to guide the evidence-based treatment of CHIKV arthritis. The main
goal of this proposal is to determine the efficacy and pathologic effects on synovitis of 6 months of
methotrexate (n=100) versus placebo (n=100) therapy for chronic CHIKV arthritis in Colombia in a randomized
controlled trial. Our central hypothesis is that methotrexate will significantly decrease the chronic CHIKV
arthritis disease severity compared to placebo and effect CHIKV-induced synovitis via suppression of leukocyte
accumulation in synovial tissue. This hypothesis will be evaluated in 2 specific aims. In Aim 1, we will determine
the efficacy of oral methotrexate treatment versus placebo for 6 months in chronic CHIKV arthritis. In Aim 2, we
will determine the effect of methotrexate on synovial inflammation by obtaining synovial biopsy samples before
and after treatment. Rationale: This work will define the role of methotrexate in the treatment of chronic CHIKV
arthritis with the goal of advancing the field towards an evidence-based standard treatment. The potential
broader impact of this work is the potential identification of the pathologic mechanism of chronic viral arthritis
and a possible therapeutic option.

## Key facts

- **NIH application ID:** 9883097
- **Project number:** 1R34AR075304-01A1
- **Recipient organization:** GEORGE WASHINGTON UNIVERSITY
- **Principal Investigator:** Aileen Chang
- **Activity code:** R34 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $351,997
- **Award type:** 1
- **Project period:** 2020-04-01 → 2022-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9883097

## Citation

> US National Institutes of Health, RePORTER application 9883097, Methotrexate treatment of Arthritis caused by Chikungunya virus (MARCH): A randomized controlled trial of methotrexate versus placebo in the treatment of chronic arthritis after chikungunya infection (1R34AR075304-01A1). Retrieved via AI Analytics 2026-06-12 from https://api.ai-analytics.org/grant/nih/9883097. Licensed CC0.

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