Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2018 May 21;11(1):320.
doi: 10.1186/s13104-018-3420-8.

Adding colchicine to immunosuppressive treatments; a potential option for biologics-refractory adult-onset Still's disease

Tomoyuki Asano  1 , Makiko Yashiro Furuya  1 , Shuzo Sato  1 , Hiroko Kobayashi  1 , Hiroshi Watanabe  1 , Eiji Suzuki  1 , Kiyoshi Migita  2
Affiliations
Case Reports

Adding colchicine to immunosuppressive treatments; a potential option for biologics-refractory adult-onset Still's disease

Tomoyuki Asano et al. BMC Res Notes. .

Abstract

Background: Adult-onset Still's disease (AOSD) is a rare inflammatory disorder characterized by the classical triad of daily spiking fever, arthritis, and typical salmon-colored rash. Resistance to first-line corticosteroids and second-line disease modified anti-rheumatic-drugs defines refractory AOSD, which mostly includes the polycyclic or chronic courses of the disease. Anti-cytokine therapies are recommended in AOSD patients who are refractory to traditional treatments. This is the first report on the efficacy of colchicine in a patient with AOSD which was refractory to immunosuppressive treatments including biologics.

Case presentation: A 24-years Japanese female patient was referred to our hospital for the flare-up of AOSD under the combined treatments with steroid, immunosuppressants, and biologics. She was diagnosed with AOSD according to the Yamaguchi criteria, based on the presence of spiking fever, polyarthralgia, skin rash, and hyperferritinemia. Interleukin-6 or tumor necrosis factor-α blockade treatments were not effective, the oral administration of colchicine was stared under the immunosuppressive treatments with steroid and cyclosporine A (CyA). Colchicine treatment silenced the disease activity of AOSD. The dose of prednisolone was successfully tapered, and the elevated levels of C-reactive protein were normalized. Remission has been maintained for 13 months with the start of oral administration of colchicine.

Conclusion: We concluded that colchicine is an alternative treatment in patients with refractory AOSD, particularly in those with impaired therapeutic effects against anti-cytokines therapies.

Keywords: Adult-onset Still’s disease; Colchicine; Cyclosporin A; Tocilizumab.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Clinical course of the patient. PSL prednisolone, TAC tacrolimus, MTX methotrexate, TCZ tocilizumab, iv. intravenous, sc. subcutaneous, IFX infliximab, CyA cyclosporine, CRP C-reactive protein, SSA serum amyloid A
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Efthimiou P, Georgy S. Pathogenesis and management of adult-onset Still’s disease. Semin Arthritis Rheum. 2006;36(3):144–152. doi: 10.1016/j.semarthrit.2006.07.001. - DOI - PubMed
    1. Gerfaud-Valentin M, Jamilloux Y, Iwaz J, Sève P. Adult-onset Still’s disease. Autoimmun Rev. 2014;13(7):708–722. doi: 10.1016/j.autrev.2014.01.058. - DOI - PubMed
    1. Lenert A, Yao Q. Macrophage activation syndrome complicating adult onset Still’s disease: a single center case series and comparison with literature. Semin Arthritis Rheum. 2016;45:711–716. doi: 10.1016/j.semarthrit.2015.11.002. - DOI - PubMed
    1. Maria AT, Le Quellec A, Jorgensen C, Touitou I, Rivière S, Guilpain P. Adult onset Still’s disease (AOSD) in the era of biologic therapies: dichotomous view for cytokine and clinical expressions. Autoimmun Rev. 2014;11:1149–1159. doi: 10.1016/j.autrev.2014.08.032. - DOI - PubMed
    1. Kontzias A, Efthimiou P. The use of Canakinumab, a novel IL-1β long-acting inhibitor, in refractory adult-onset Still’s disease. Semin Arthritis Rheum. 2012;42(2):201–205. doi: 10.1016/j.semarthrit.2012.03.004. - DOI - PubMed

Publication types

MeSH terms

LinkOut - more resources