A growing body of evidence suggests the usability of biologic disease-modifying anti-rheumatic drugs (bDMARDs) in treating adult-onset Still’s disease (AOSD). In a multicentre “real-life” cohort, the physicians’ prescribing motivations and patients’ predictive characteristics of being treated with bDMARDs were assessed. Patients with AOSD, who were included in GIRRCS (Gruppo Italiano di Ricerca in Reumatologia Clinica e Sperimentale) cohort and treated with bDMARDs, were retrospectively assessed. Relevant data were collected by a review of clinical charts. Forty-four patients treated with bDMARDs were analysed, with slight male preponderance (52.3%) and a mean age of 39.3 ± 15.2 years. All patients were treated with corticosteroids (CCSs) (38.6% with low dosage) and 93.2% were treated with synthetic DMARDs (sDMARDs). Regarding the effectiveness of the first-line bDMARD, 65.6% of patients experienced a complete remission, defined as complete disappearance of both systemic and joint symptoms and normalisation of laboratory evidence of disease. The physicians’ prescribing motivations for bDMARDs were inadequate response to CCSs and/or sDMARDs, CCS-sparing effect and occurrence of macrophage activation syndrome (MAS). Analysing patients’ characteristics, chronic disease course (OR 3.09; 95%CI 1.22–7.80, p = 0.017), defined as disease with persistent symptoms, was predictive of being treated with bDMARDs, whereas age (OR 0.97, 95%CI 0.93–0.99, p = 0.048) was negatively associated, suggesting younger age as a further predictive factor. Patients with AOSD were treated with bDMARDs for inadequate response to CCSs and/or sDMARDs, CCS-sparing effect and MAS occurrence. Younger age and chronic disease course were patients’ predictive characteristics of being treated with bDMARDs.

中文翻译：

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与成年Still病中使用生物药物有关的动机和患者特征的处方：多中心“现实生活”队列分析

越来越多的证据表明，改良生物疾病的抗风湿药（bDMARDs）在治疗成人发作的斯蒂尔氏病（AOSD）中的可用性。在一个多中心的“现实生活”队列中，评估了医生用bDMARD治疗的处方动机和患者的预测特征。回顾性评估了GIRSCS（Reumatologia Clinica e Sperimentale中的Gruppo Italiano di Ricerca）队列并接受bDMARDs治疗的AOSD患者。通过回顾临床图表收集相关数据。分析了44例接受bDMARD治疗的患者，其中男性占优势（52.3％），平均年龄为39.3±15.2岁。所有患者均接受皮质类固醇（CCSs）治疗（低剂量时占38.6％），93.2％的患者接受合成DMARDs（sDMARDs）治疗。关于一线bDMARD的有效性，有65.6％的患者经历了完全缓解，这被定义为全身和关节症状完全消失以及疾病的实验室证据正常化。医师对bDMARDs开处方的动机是对CCS和/或sDMARDs反应不充分，CCS保留效应和巨噬细胞活化综合征（MAS）的发生。分析患者的特征，慢性病进程（OR 3.09； 95％CI 1.22–7.80，CCS保留效应和巨噬细胞活化综合征（MAS）的发生。分析患者的特征，慢性病进程（OR 3.09； 95％CI 1.22–7.80，CCS保留效应和巨噬细胞活化综合征（MAS）的发生。分析患者的特征，慢性病进程（OR 3.09； 95％CI 1.22–7.80，p  = 0.017）被定义为具有持续性症状的疾病，预示将接受bDMARDs治疗，而年龄（OR 0.97，95％CI 0.93–0.99，p  = 0.048）呈负相关，表明年龄更小是进一步的预测因素。AOSD患者因对CCS和/或sDMARD的反应，CCS保留效应和MAS发生率不足而接受了bDMARDs治疗。较年轻的年龄和慢性病病程是患者接受bDMARDs治疗的预测特征。