Rheumatology Unit, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
Department of Medical Sciences, Surgery and Neurosciences, Research Center of Systemic Autoinflammatory Diseases and Behçet's Disease Clinic, University of Siena, Siena, Italy.
Semin Arthritis Rheum. 2023 Oct;62:152244. doi: 10.1016/j.semarthrit.2023.152244. Epub 2023 Jul 21.
To describe clinical characteristics of patients with Still's disease treated with methotrexate (MTX) and to assess drug effectiveness evaluating change in disease activity, reduction of inflammatory markers, and glucocorticoid (GC)-sparing effect.
Patients with Still's disease treated with MTX were assessed among those included in AIDA Network Still Disease Registry.
In this registry, 171 patients with Still's disease were treated with MTX (males 43.3%, age 37.1 ± 16.0 years). They were mainly characterised by joint features and fever without a prominent multiorgan involvement. MTX was administered with GCs in 68.4% of patients, with other conventional synthetic DMARDs in 6.4%, and with biologic DMARDs in 25.1%. A significant reduction of the modified systemic score was observed, and 38.6% patients were codified as being in clinical remission at the end of follow-up. The concomitant administration of a biologic DMARD resulted a predictor of the clinical remission. Furthermore, a reduction of inflammatory markers and ferritin levels was observed following the administration of MTX. Additionally, a marked reduction of the dosage of concomitant GCs was identified, while 36.7% discontinued such drugs. Male gender appeared as a predictor of GC discontinuation. MTX was discontinued in 12.3% of patients because of adverse effects, and in 12.3% for lack of efficacy.
Clinical characteristics of patients with Still's disease treated with MTX were described, mainly joint features and fever without a prominent multiorgan involvement. The clinical usefulness of MTX was reported in reducing the disease activity, decreasing the inflammatory markers, and as GC-sparing agent.
描述接受甲氨蝶呤（MTX）治疗的斯蒂尔病患者的临床特征，并评估药物疗效，评估疾病活动度的变化、炎症标志物的降低以及糖皮质激素（GC）的节省效应。
在 AIDA 网络斯蒂尔病登记处中评估接受 MTX 治疗的斯蒂尔病患者。
在该登记处中，有 171 例斯蒂尔病患者接受 MTX 治疗（男性占 43.3%，年龄 37.1±16.0 岁）。他们主要表现为关节表现和发热，无明显多器官受累。68.4%的患者接受 MTX 联合 GC 治疗，6.4%的患者接受其他传统合成 DMARD 治疗，25.1%的患者接受生物 DMARD 治疗。观察到改良全身评分显著降低，38.6%的患者在随访结束时被编码为临床缓解。同时使用生物 DMARD 是临床缓解的预测因素。此外，接受 MTX 治疗后观察到炎症标志物和铁蛋白水平降低。此外，发现同时使用的 GC 剂量明显减少，而 36.7%的患者停止使用此类药物。男性是 GC 停药的预测因素。由于不良反应，12.3%的患者停用 MTX，12.3%的患者因疗效不佳而停用 MTX。
描述了接受 MTX 治疗的斯蒂尔病患者的临床特征，主要为关节表现和发热，无明显多器官受累。报告了 MTX 在降低疾病活动度、降低炎症标志物以及作为 GC 节省剂方面的临床应用价值。
