Still's Disease - Treatment

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What is the treatment for Still's disease?

Still's disease can cause serious damage to the joints, particularly the wrists. It can also impair the function of the heart and lungs. Treatment of Still's disease is directed toward the individual areas of inflammation. Many symptoms are often controlled with anti-inflammatory drugs such as aspirin or other nonsteroidal drugs (NSAIDs). It has been reported that some patients with Still's disease can frequently have elevations of liver function blood tests as a side effect of aspirin and sometimes other anti-inflammatory medications. Cortisone medications (steroids) such as prednisone are used to treat more severe features of illness.

For patients with persistent illness, medications that affect the inflammatory aspects of the immune system are used. Medications now being used are analogous to the classic "second-line" therapies used for patients with rheumatoid arthritis. These include gold, hydroxychloroquine (Plaquenil), penicillamine (Cuprimine, Depen), azathioprine (Imuran), methotrexate (Rheumatrex, Trexall), and cyclophosphamide (Cytoxan).

Most recently, because Still's disease has been found to involve a specific chemical messenger of inflammation known as interleukin 1 (IL-1), the injectable biologic medication anakinra (Kineret), which blocks IL-1, has been found to be an effective treatment for Still's disease.

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Comment from: Frank B, 45-54 Male (Patient) Published: June 19

I was diagnosed with Still's disease in October 2003. After 10 months of severe fevers, rash, night sweats, weight loss (over 30 lb.), 2 stints in the hospital, a bankruptcy, my wife left me, methotrexate, prednisone, CellCept, Enbrel, Remicade, gold shots, and countless other drugs, I finally got to Kineret. Symptoms went away almost instantly. I took 1 shot a day for nearly 5 years and became fully functional with no side effects. Then I took my last shot in November 2009. No more symptoms at all till April 2014. It then came on with a vengeance. Fevers, able to hardly move, big time rashes, and night sweats. Now they want to try Actemra. I am on prednisone right now but it has little effect. I still miss work about 50% of the time. Hopefully it is approved soon.

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Comment from: Lucy1, 45-54 Female (Patient) Published: July 24

I have Stills disease. I became ill in 2011 with high spiking fevers at night and drenching sweats. I also had myalgia and was very lethargic. After 2 months I lost vision and fainted. In the emergency room I was admitted to a wonderful teaching hospital and in 2 weeks was diagnosed. I have been on many medicines but the best regimen is Actemra and methotrexate. Actemra is a fantastic drug.

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