Korean J Med.  2012 Apr;82(4):520-524.

Two Cases of Refractory Adult-Onset Still's Disease Responding to Anakinra

• Oh JM
• Kim H
• Lee J
• Ahn JK
• Lee YS
• Koh EM
• Cha HS

Abstract

Adult-onset Still's disease (AOSD) is a systemic inflammatory disorder with variable clinical features. The interleukin (IL)-1 receptor antagonist anakinra has been proposed as an alternative effective treatment in refractory AOSD. We report, for the first time in Korea, two cases of refractory AOSD in which anakinra treatment produced a clinical response. The first patient had frequent clinical flare-ups with fever, sore throat, myalgia, and pleuritic chest pain despite treatment with methotrexate and etanercept. In the second patient, treatments with various immunosuppressive agents failed to control the disease activity. Treatment with anakinra 100 mg/day was initiated in both cases. A complete clinical remission and improvement in the laboratory parameters were observed. The steroid dose was tapered without further clinical flare-ups. Anakinra appears to be an effective alternative treatment modality in patients with AOSD refractory to conventional disease-modifying anti-rheumatic drugs and corticosteroid therapy.

Keyword

Anakinra; Adult-onset Still's disease (AOSD)

MeSH Terms

Antirheumatic Agents
Chest Pain
Fever
Humans
Immunoglobulin G
Immunosuppressive Agents
Interleukin 1 Receptor Antagonist Protein
Interleukins
Korea
Methotrexate
Pharyngitis
Receptors, Tumor Necrosis Factor
Still's Disease, Adult-Onset
Etanercept
Antirheumatic Agents
Immunoglobulin G
Immunosuppressive Agents
Interleukin 1 Receptor Antagonist Protein
Interleukins
Methotrexate
Receptors, Tumor Necrosis Factor