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
Observational Study
. 2019 Apr;98(15):e15123.
doi: 10.1097/MD.0000000000015123.

Managing Adult-onset Still's disease: The effectiveness of high-dosage of corticosteroids as first-line treatment in inducing the clinical remission. Results from an observational study

Piero Ruscitti  1 , Paola Cipriani  1 , Vasiliki Liakouli  1 , Giuliana Guggino  2 , Francesco Carubbi  1 , Onorina Berardicurti  1 , Francesco Ciccia  2 , Roberto Giacomelli  1
Affiliations
Observational Study

Managing Adult-onset Still's disease: The effectiveness of high-dosage of corticosteroids as first-line treatment in inducing the clinical remission. Results from an observational study

Piero Ruscitti et al. Medicine (Baltimore). 2019 Apr.

Abstract

To assess the effectiveness of the treatment with high dosage of corticosteroids (CCSs), as first-line therapy, in inducing remission in naïve Adult-onset Still's disease (AOSD) patients compared with low dosage of CCSs, after 6 months. To further evaluate the rate of patients maintaining the remission and the rate of CCSs discontinuation, after additional 12 months of follow-up.A retrospective evaluation of patients prospectively followed was designed to compare the rate of clinical remission in naïve AOSD patients treated with high dosages of CCSs (0.8-1 mg/kg/day of prednisone-equivalent) or low dosage of CCSs (0.2-0.3 mg/kg/day of prednisone-equivalent), after 6 months. An additional analysis was performed to compare the rate of monocyclic pattern between these groups, after further 12 months of follow-up.The clinical remission was achieved in a higher percentage of patients treated with the first-line treatment with high dosage of CCSs than treated the first-line treatment with low dosage of CCSs. At the end of 18 months of follow-up, a larger percentage of patients treated the first-line treatment with high dosage of CCSs was classified as monocyclic pattern and discontinued CCSs when compared with patients treated the first-line treatment with low dosage of CCSs. Patients defined as CCSs non-responder were treated with methotrexate (MTX)+CCSs or with combination therapy CCSs+MTX+biologic drug. The clinical remission was observed in a percentage of these patients.We showed the effectiveness of the first-line treatment with high dosage of CCSs in inducing clinical remission in naïve AOSD patients when compared with the first-line treatment with low dosage of CCSs. The first-line treatment with high dosage of CCSs was also associated with the achievement of monocyclic pattern and CCSs discontinuation, after 18 months of follow-up.

PubMed Disclaimer

Conflict of interest statement

The authors have no conflicts of interest to disclose.

References

    1. Ruscitti P, Giacomelli R. Pathogenesis of adult onset still's disease: current understanding and new insights. Expert Rev Clin Immunol 2018;14:965–76. - PubMed
    1. Efthimiou P, Kadavath S, Mehta B. Life-threatening complications of adult-onset Still's disease. Clin Rheumatol 2014;33:305–14. - PMC - PubMed
    1. Ruscitti P, Rago C, Breda L, et al. Macrophage activation syndrome in Still's disease: analysis of clinical characteristics and survival in paediatric and adult patients. Clin Rheumatol 2017;36:2839–45. - PubMed
    1. Ruscitti P, Cipriani P, Ciccia F, et al. Prognostic factors of macrophage activation syndrome, at the time of diagnosis, in adult patients affected by autoimmune disease: analysis of 41 cases collected in 2 rheumatologic centers. Autoimmun Rev 2017;16:16–21. - PubMed
    1. Ruscitti P, Cipriani P, Ciccia F, et al. H-ferritin and CD68(+) /H-ferritin(+) monocytes/macrophages are increased in the skin of adult-onset Still's disease patients and correlate with the multi-visceral involvement of the disease. Clin Exp Immunol 2016;186:30–8. - PMC - PubMed

Publication types