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Disease Activity Scoring in Adult-onset Still's disease
Still's disease in adults (AOSD) or children (sJIA) can have dramatic symptom severity, making it easy to gauge disease activity and response to therapy, especially at the outset. However, a validated measure of disease activity has not been agreed (for clinical trial and treatment assessments). A new study compares two such activity measuresin a large cohort of Still's patients.
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Axial Psoriatic Arthritis and Ankylosing Spondylitis with Psoriasis
A cohort analysis from Toronto suggests that axial psoriatic arthritis (PsA) is distinctly different from axial ankylosing spondylitis (AS) with psoriasis.
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JAK Inhibitors in Difficult Still’s Disease
A small retrospective study suggests that patients with difficult to treat adult-onset Still's disease (AOSD) or sytemic juvenile idiopathic arthritis (sJIA) may respond well to JAK inhibitor (JAKi) agents - presumable by blocking pro-inflammatory cytokines, notably IL-6 and IFN.
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Not Still’s – Now What?
Your patient doesn't meet criteria for Still’s disease (AOSD or sJIA), now what should you do or consider?
What you do or consider next can be addressed according to the stage of current disease: A) Hospitalized Febrile Disease, or B) Outpatient “Still’s” Disease.
Rheumatic Causes for Fever of Unknown Origin
Fever of unknown origin (FUO) represents a diagnostic challenge to many physicians and while cancer and infectious causes need to be excluded, rheumatic disorders are amongst the most common causes of FUO.
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Best Labs for Still’s Disease
There is no “test” (blood or other) that is solely diagnostic of Still’s disease, but labs can help make a diagnosis or manage disease, and affirm the safety of drugs in use.
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Recent review of AOSD suggests: - AOSD & SJIA are the same - Classify dz as systemic or articular - #MAS occurs in up to 23% - Yamaguchi & Fautrel criteria are widely used - Cytokines important: IL-1, IL-6, IL-18, IL-37 - only Canakinumab is FDA-approved https://t.co/4ERA56Wqcb https://t.co/FkIWxIrwxX
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