Rheumatology Clinic, Azienda Ospedaliero Universitaria S. Maria della Misericordia, Udine, Italy.
Clin Exp Rheumatol. 2010 Mar-Apr;28(2):265-7. Epub 2010 May 13.
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.
成人斯蒂尔病（AOSD）是一种全身炎症性疾病，其特征为高热、皮疹和关节炎。一线治疗包括皮质类固醇。甲氨蝶呤常用于耐药病例或作为皮质类固醇节约药物。在风湿性疾病中生物药物的出现，如抗 TNF 和 IL-1ra，使非常难治性 AOSD 病例的治疗成为可能，并为病理生理学提供了新的线索。然而，阿那白滞素和抗 TNF 也可能在 AOSD 中失败或禁忌，因此需要其他治疗策略。鉴于 T 细胞激活可能是 AOSD 病理生理学的一个相关部分，阿巴西普，CTLA4IgFc，在一名 57 岁男性中使用，该男性患有 AOSD，对传统 DMARDs 和抗 IL-1 和抗 TNF 治疗均耐药，结果良好。
