Efficacy of abatacept in a refractory case of adult-onset Still's disease.
Adult-onset Still's disease (AOSD) is a systemic inflammatory disorder, characterized by spiking fever, skin rash, and arthritis. First-line treatment consists of corticosteroids. Methotrexate is commonly used in resistant cases or as a steroid-sparing drug. The availability of biologic drugs in the rheumatic diseases, such as anti-TNFs and IL-1ra, has allowed to treat very refractory cases of AOSD and provided new clues for the pathophysiology. However, anakinra and anti-TNFs may also fail or may be contraindicated in AOSD, and other treatment strategies are then necessary. Given that T cell activation may be a relevant part of the AOSD pathophysiology, abatacept, CTLA4IgFc, was administered in a 57-year-old man with AOSD failing traditional DMARDs and to anti-IL-1 and anti-TNF therapies, with a good outcome.
Quartuccio
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L
Rheumatology Clinic, Azienda Ospedaliero Universitaria S. Maria della Misericordia, Udine, Italy.
Maset
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M
De Vita
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D000069594:Abatacept; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D006801:Humans; D018796:Immunoconjugates / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011859:Radiography; D012074:Remission Induction; D016706:Still's Disease, Adult-Onset / Q000000981:diagnostic imaging / Q000188:drug therapy*
D018501:Antirheumatic Agents; D018796:Immunoconjugates; D000069594:Abatacept