title: [Biological treatment in severe Still's disease--a case report].
abstract: Still's disease and systemic juvenile idiopathic arthritis (JIA) are multisystem inflammatory diseases of unknown etiology, different disease course and prognosis. Still's disease is characterized by hectic fever, arthritis, skin rash, organomegaly, elevated serum ferritin and inflammatory factors. Early diagnosis and intensive treatment can prevent disease progression and reduce complications such as amyloidosis, physical disability. The first choice of treatment are high doses of corticosteroids and synthetic disease-modifying drugs (DMARDs), including methotrexate (MTX), cyclosporine (CsA). Biologic agents are second line therapy when DMARDs aren't effective, e.g. monoclonal antibodies blocking the action of TNF-alpha (anti-TNF-α), interleukin-1 (ANK--anakinra) and interleukin-6 (TCZ--tocilizumab). We describe in details treatment strategies applied in a young woman with severe Still's disease treated with combination therapy of DMARDs and anti-TNF-α, including etanercept (ETA) or certolizumab (CER). TCZ was applied for the treatment of Still's disease following treatment failure with anti-TNF-α. We've achieved a complete remission of the Still's disease during treatment TCZ.
authors.forename: Dorota
authors.initials: D
authors.lastname: Suszek
authors.forename: Arkadiusz
authors.initials: A
authors.lastname: Koszarny
authors.forename: Radosław
authors.initials: R
authors.lastname: Jeleniewicz
authors.forename: Maria
authors.initials: M
authors.lastname: Majdan
authors.forename: Anna
authors.initials: A
authors.lastname: Bończak
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Czukiewska
authors.forename: Barbara
authors.initials: B
authors.lastname: Koszła
authors.forename: Sylwia
authors.initials: S
authors.lastname: Kurlej
authors.forename: Justyna
authors.initials: J
authors.lastname: Markowicz
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Szymczyk
mesh_terms: D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001171:Arthritis, Juvenile / Q000188:drug therapy*; D000068582:Certolizumab Pegol; D018450:Disease Progression; D004359:Drug Therapy, Combination; D000068800:Etanercept; D005260:Female; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000008:administration & dosage*; D007074:Immunoglobulin G / Q000008:administration & dosage; D008727:Methotrexate / Q000008:administration & dosage; D011092:Polyethylene Glycols / Q000008:administration & dosage*; D018124:Receptors, Tumor Necrosis Factor / Q000008:administration & dosage; D012074:Remission Induction; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*; D055815:Young Adult; D000093242:Interleukin-6 Inhibitors
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; D000068582:Certolizumab Pegol; D000068800:Etanercept; D007140:Immunoglobulin Fab Fragments; D007074:Immunoglobulin G; D008727:Methotrexate; D011092:Polyethylene Glycols; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D000093242:Interleukin-6 Inhibitors; C502936:tocilizumab