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 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, has been approved by the FDA to treat systemic JIA in children.

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Comment from: MadMan, (Patient) Published: October 30

Methotrexate seems to have helped my adult onset Still's disease at age 62 which made it difficult to diagnose. Maybe my acute phase is not as severe as others but I find walking in the park helps me to relax and stay mobile. I stopped working because of illness and age but fortunately we own our own apartment and my younger wife works.

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Comment from: astrid twidale, 65-74 (Caregiver) Published: November 11

I was 19 years old when my fevers started doctors did not know what the problem was. I had an infection from my heart muscle and was very anemic. I got a blood transfusion and was treated with cortisone; I was free for years. In 1977 the fevers came back again, with enlarged liver and spleen, tiredness and night sweats. I was in hospital for 6 weeks and got better, but no diagnosis and no medication. In 1982 I had small fevers again after my children. From time to time I always had small fevers with enlarged spleen, liver, and glands, and iron was short. In 1987, after lots of tests I was put on Meticorten (cortisone) for 6 years. My last small fever I had in 1994 after I moved into my new house. I stopped cortisone end of 1994. I was the 43 years old. I am now 65 and have been in perfect health since 1994. When my son started when he was 14 years old and much later was told he got still's disease, then only I got to know what I had. I hope that he will be cured as I am.

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