Is anti-TNF switching in refractory Still’s disease safe and effective?

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CASE BASED REVIEW

Is anti-TNF switching in refractory Still’s disease safe and effective?

http://www.springerlink.com/content/k740073636hu5301/

CLINICAL RHEUMATOLOGY DOI: 10.1007/s10067-011-1735-0

Abstract

Still’s disease (SD) is a rare chronic inflammatory disease characterized by

polyarthritis, systemic symptoms, and elevated inflammatory markers.

Of note, 74 SD cases were reported with anti-tumoral necrosis factor (TNF)

therapy and the experience of switching is limited to five patients.

During a 3-year period, SD cases were 1.9% of 319 rheumatic patients that

received anti-TNF agents in the infusion center of our University Hospital.

In this manuscript, the authors add six new cases of refractory SD who had

clinical and laboratory response to TNF blockers and report the outcome of

switching in five of them.

Partial or complete response was achieved by four of six (66.7%) patients

and three of four (75%) required switching.

Regarding safety, five of six (83.3%) had adverse events. Anti-TNF treatment

with switching seems to be a valid approach for refractory SD patients.