Abstract |
To assess the effectiveness of the treatment with high dosage of corticosteroids (CCSs), as first-line therapy, in inducing remission in naïve Adult-onset Still's disease (AOSD) patients compared with low dosage of CCSs, after 6 months. To further evaluate the rate of patients maintaining the remission and the rate of CCSs discontinuation, after additional 12 months of follow-up.A retrospective evaluation of patients prospectively followed was designed to compare the rate of clinical remission in naïve AOSD patients treated with high dosages of CCSs (0.8-1 mg/kg/day of prednisone-equivalent) or low dosage of CCSs (0.2-0.3 mg/kg/day of prednisone-equivalent), after 6 months. An additional analysis was performed to compare the rate of monocyclic pattern between these groups, after further 12 months of follow-up.The clinical remission was achieved in a higher percentage of patients treated with the first-line treatment with high dosage of CCSs than treated the first-line treatment with low dosage of CCSs. At the end of 18 months of follow-up, a larger percentage of patients treated the first-line treatment with high dosage of CCSs was classified as monocyclic pattern and discontinued CCSs when compared with patients treated the first-line treatment with low dosage of CCSs. Patients defined as CCSs non-responder were treated with methotrexate (MTX)+CCSs or with combination therapy CCSs+MTX+ biologic drug. The clinical remission was observed in a percentage of these patients.We showed the effectiveness of the first-line treatment with high dosage of CCSs in inducing clinical remission in naïve AOSD patients when compared with the first-line treatment with low dosage of CCSs. The first-line treatment with high dosage of CCSs was also associated with the achievement of monocyclic pattern and CCSs discontinuation, after 18 months of follow-up.
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Authors | Piero Ruscitti, Paola Cipriani, Vasiliki Liakouli, Giuliana Guggino, Francesco Carubbi, Onorina Berardicurti, Francesco Ciccia, Roberto Giacomelli |
Journal | Medicine
(Medicine (Baltimore))
Vol. 98
Issue 15
Pg. e15123
(Apr 2019)
ISSN: 1536-5964 [Electronic] United States |
PMID | 30985672
(Publication Type: Comparative Study, Journal Article, Observational Study)
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Chemical References |
- Adrenal Cortex Hormones
- Methotrexate
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Topics |
- Adrenal Cortex Hormones
(administration & dosage, adverse effects)
- Adult
- Disease Management
- Dose-Response Relationship, Drug
- Female
- Follow-Up Studies
- Humans
- Male
- Methotrexate
(therapeutic use)
- Middle Aged
- Prospective Studies
- Remission Induction
- Retrospective Studies
- Still's Disease, Adult-Onset
(therapy)
- Treatment Outcome
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