Comparative analysis of adult-onset Still's disease (AOSD) treatments

Conditions

Treatments of Adult-onset Still's Disease (AOSD, rheumatic disease) Musculoskeletal Diseases

Vordenbäumen S, Filla T, Friedrich R, Blank N, Ernst D, Henes J, Keyßer G, Klemm P, Krusche M, Meinecke A, Rech J, Schulz N, Petzinna SM, Pankow A, Schäfer VS, Pfeil A, Klapa S, Pongratz G, Feist E, Kernder A.

2026-09-04

10.1136/rmdopen-2026-007112

Stellenwert von Biologika in erster Therapielinie beim AOSD

Philipp Sewerin

Kompass Autoimmun2025-07-31

10.1159/000546829

First-line biological versus conventional synthetic disease-modifying antirheumatic drug therapy in adult-onset Still's disease: a multicentre, retrospective, propensity weighted cohort study.

Kernder A, Filla T, Friedrich R, Blank N, Ernst D, Henes J, Keyßer G, Klemm P, Krusche M, Meinecke A, Rech J, Schulz N, Petzinna SM, Pankow A, Schäfer VS, Pfeil A, Klapa S, Feist E, Vordenbäumen S.

2025-03-282 citations

10.1016/s2665-9913(25)00023-2

Interventions

Retrospective Observational study Data collected: - Epidemiological data (age at onset, sex, height, weight, comorbidities) - Disease activity data (items of the Pouchot Score, CRP, Ferritin, Leuko

Eligibility

Sex/Gender

All

Age

18 Years to 100 Years

Inclusion criteria

Inclusion criteria: 1. Yamaguchi classification criteria are met 2. Documented clinical visits at onset/flare, by week 12 and week 72

Exclusion criteria

Exclusion criteria: Not matching the inclusion criteria

Design outcomes

Primary

Measure	Time frame
Sustained remission (definition see below) at week 12 and complication free until week 72 (definition see below). For remission, all of the below must be fulfilled: 1. Physician subjective evaluation of “remission” based on chart review 2. CRP below 10 mg/l 3. No fever during last week 4. No arthritis during last week 5. No ASOD-associated rash during last week For Complication-free (none of the following should have been appeared): 1. Complications of GC use 2. Diabetes necessitating insulin therapy 3. Gain in body weight (= 10%) 4. Osteonecrosis of any joint 5. Psychosis or other psychiatric disease requiring psychopharmacological intervention 6. Hypertension > 180 mmHg systolic pressure resulting in change of antihypertensive medication 7. Dyslipidemia requiring therapy with e.g. statins 8. Worsening of bone density > 0,5 SD (T1-4, neck or total hip), preexisting osteoporosis or osteoporosis diagnosed within 2 months of disease onset is not considered to be a GC-related event 9. Clinical diagnosis of steroid myopathy 10. Skin disease attributed to GC, e.g. striae, cutaneous necrosis, relevant subcutaneous bleeding or ulcerations 11. Eye disease attributable to GC (esp. cataract, glaucoma) 12. Serious infection necessitating intravenous antibiotic use 13. Death 14. Development of macrophage activation syndrome, AOSD-associated pneumonitis, ASOD-associated peri myocarditis 15. Ongoing disease activity requiring switch from DMARD-based to biological therapy	—

Measure

Time frame

Sustained remission (definition see below) at week 12 and complication free until week 72 (definition see below). For remission, all of the below must be fulfilled: 1. Physician subjective evaluation of “remission” based on chart review 2. CRP below 10 mg/l 3. No fever during last week 4. No arthritis during last week 5. No ASOD-associated rash during last week For Complication-free (none of the following should have been appeared): 1. Complications of GC use 2. Diabetes necessitating insulin therapy 3. Gain in body weight (= 10%) 4. Osteonecrosis of any joint 5. Psychosis or other psychiatric disease requiring psychopharmacological intervention 6. Hypertension > 180 mmHg systolic pressure resulting in change of antihypertensive medication 7. Dyslipidemia requiring therapy with e.g. statins 8. Worsening of bone density > 0,5 SD (T1-4, neck or total hip), preexisting osteoporosis or osteoporosis diagnosed within 2 months of disease onset is not considered to be a GC-related event 9. Clinical diagnosis of steroid myopathy 10. Skin disease attributed to GC, e.g. striae, cutaneous necrosis, relevant subcutaneous bleeding or ulcerations 11. Eye disease attributable to GC (esp. cataract, glaucoma) 12. Serious infection necessitating intravenous antibiotic use 13. Death 14. Development of macrophage activation syndrome, AOSD-associated pneumonitis, ASOD-associated peri myocarditis 15. Ongoing disease activity requiring switch from DMARD-based to biological therapy

—

Secondary

Measure	Time frame
1. Flare-free survival in patients under remission 2. Rate of remission (definition see below) by week 12 and complication free by week 72 3. Retrospective analysis of differences in the glucocorticoid toxicity index (GTI) 4. GC dose reduction (at week 12 and week 72) 5. GC dose reduction by at least 75% compared to disease onset 6. Time to remission 7. Time to complication (definition see above) 8. Complications (definition see above)	—

Measure

Time frame

1. Flare-free survival in patients under remission 2. Rate of remission (definition see below) by week 12 and complication free by week 72 3. Retrospective analysis of differences in the glucocorticoid toxicity index (GTI) 4. GC dose reduction (at week 12 and week 72) 5. GC dose reduction by at least 75% compared to disease onset 6. Time to remission 7. Time to complication (definition see above) 8. Complications (definition see above)

—

Countries

Germany

Contacts

Public ContactAnna Kernder

anna_kernder@t-online.de+49 02118100

Outcome results

None listed