Refractory Adult-onset Still's Disease Treated with a Combination of Methotrexate and Etanercept.

IF 1.2 Q4 RHEUMATOLOGY

Current rheumatology reviews Pub Date : 2024-01-01 DOI:10.2174/0115733971244440230921100912

Georges El Hasbani, Yaser Ahmad, Michael Cassetta

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引用次数: 0

Abstract

Background: Adult-onset Still's disease (AOSD) is a challenging diagnosis because of the variability in clinical presentation and lack of gold-standard diagnostic investigations. Even after diagnosis, the treatment is challenging, especially when the disease is refractory to first-line therapy. Multiple pharmacotherapeutic options exist for refractory AOSD, but treatment failures still occur. Etanercept, a Tumor necrosis factor (TNF)-alpha inhibitor, is one of the options that has been rarely used for refractory AOSD, with various outcomes ranging from no response to complete remission.

Case presentation: In this case, we highlight how a previously healthy lady had refractory AOSD to glucocorticoids, methotrexate, and hydroxychloroquine combination therapy. There was no response to interleukin (IL)-1 therapy, which necessitated a switch to a combination of etanercept, low-dose methotrexate, and low-dose glucocorticoids with complete remission for a total of three- -year follow-up.

Conclusion: The combination of methotrexate and Etanercept can maintain remission in patients with refractory AOSD.

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甲氨蝶呤和依那西普联合治疗成人顽固性斯蒂尔病。

背景：成人斯蒂尔病（AOSD）是一种具有挑战性的诊断，因为临床表现的可变性和缺乏金标准的诊断研究。即使在确诊后，治疗也是具有挑战性的，尤其是当疾病对一线治疗难以治疗时。难治性AOSD存在多种药物治疗选择，但治疗失败仍有发生。依那西普是一种肿瘤坏死因子（TNF）-α抑制剂，是很少用于难治性AOSD的选择之一，其结果从无反应到完全缓解不等。病例介绍：在这种情况下，我们强调了一位先前健康的女性是如何对糖皮质激素、甲氨蝶呤和羟氯喹联合治疗产生难治性AOSD的。白细胞介素（IL）-1治疗无反应，需要改用依那西普、低剂量甲氨蝶呤和低剂量糖皮质激素的联合治疗，在总共三年的随访中完全缓解。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current rheumatology reviews RHEUMATOLOGY-

CiteScore

2.30

自引率

0.00%

发文量

期刊介绍： Current Rheumatology Reviews publishes frontier reviews on all the latest advances on rheumatology and its related areas e.g. pharmacology, pathogenesis, epidemiology, clinical care, and therapy. The journal"s aim is to publish the highest quality review articles dedicated to clinical research in the field. The journal is essential reading for all researchers and clinicians in rheumatology.