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Is anti-TNF switching in refractory Still’s disease safe and effective?

Clinical Rheumatology volume 30, pages 1129–1134 (2011)Cite this article

Abstract

Still’s disease (SD) is a rare chronic inflammatory disease characterized by polyarthritis, systemic symptoms, and elevated inflammatory markers. Of note, 74 SD cases were reported with anti-tumoral necrosis factor (TNF) therapy and the experience of switching is limited to five patients. During a 3-year period, SD cases were 1.9% of 319 rheumatic patients that received anti-TNF agents in the infusion center of our University Hospital. In this manuscript, the authors add six new cases of refractory SD who had clinical and laboratory response to TNF blockers and report the outcome of switching in five of them. Partial or complete response was achieved by four of six (66.7%) patients and three of four (75%) required switching. Regarding safety, five of six (83.3%) had adverse events. Anti-TNF treatment with switching seems to be a valid approach for refractory SD patients.

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Acknowledgments

This study was supported by grants from Fundação de Amparo à Pesquisa do Estado de São Paulo-FAPESP (2009/51897-5 to EB), Conselho Nacional de Desenvolvimento Científico e Tecnológico-CNPQ (3300665/2009-1 to JFC, 300248/2008-3 to CAS, and 301411/2009-3 to EB) and Federico Foundation (to JFC, CAS, and EB).

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Affiliations

  1. Division of Rheumatology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil

    Nadia Emi Aikawa, Ana Cristina de Medeiros Ribeiro, Carla Gonçalves Schain Saad, Mauricio Levy, Clovis A. Silva, Eloísa Bonfá & Jozélio Freire de Carvalho

  2. CEDMAC Unit, Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil

    Nadia Emi Aikawa, Ana Cristina de Medeiros Ribeiro, Carla Gonçalves Schain Saad, Rosa Maria Rodrigues Pereira, Clovis A. Silva, Eloísa Bonfá & Jozélio Freire de Carvalho

  3. Pediatric Reumatology Unit, Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil

    Nadia Emi Aikawa & Clovis A. Silva

  4. Disciplina de Reumatologia, Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Arnaldo, no. 455, 3° andar, sala 3190-Cerqueira César, São Paulo, São Paulo, Brazil, CEP 05403-010

    Jozélio Freire de Carvalho

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  1. Nadia Emi Aikawa
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  2. Ana Cristina de Medeiros Ribeiro
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  3. Carla Gonçalves Schain Saad
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  4. Rosa Maria Rodrigues Pereira
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  5. Mauricio Levy
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  6. Clovis A. Silva
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  7. Eloísa Bonfá
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  8. Jozélio Freire de Carvalho
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Corresponding author

Correspondence to Jozélio Freire de Carvalho.

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Aikawa, N.E., de Medeiros Ribeiro, A.C., Saad, C.G.S. et al. Is anti-TNF switching in refractory Still’s disease safe and effective?. Clin Rheumatol 30, 1129–1134 (2011). https://doi.org/10.1007/s10067-011-1735-0

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  • DOI: https://doi.org/10.1007/s10067-011-1735-0

Keywords

  • Adalimumab
  • Anti-TNF
  • Etanercept
  • Infliximab
  • Still’s disease
  • Switching