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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 hydroxychloroquine (Plaquenil), penicillamine (Cuprimine, Depen), azathioprine (Imuran), methotrexate (Rheumatrex, Trexall), and cyclophosphamide (Cytoxan).
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 a very effective treatment for Still's disease. Still's disease also involves interleukin 6 (IL-6). Tocilizumab (Actemra), an intravenous treatment which blocks IL-6, is approved to treat systemic JIA in children.