{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T19:15:10Z","timestamp":1740165310979,"version":"3.37.3"},"reference-count":14,"publisher":"Wiley","license":[{"start":{"date-parts":[[2013,1,1]],"date-time":"2013-01-01T00:00:00Z","timestamp":1356998400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Case Reports in Rheumatology"],"published-print":{"date-parts":[[2013]]},"abstract":"<jats:p>A 21-year-old woman with refractory systemic flare of adult-onset Still\u2019s disease with liver failure despite high-dose corticosteroids, cyclosporine, tacrolimus, and tocilizumab, was successfully treated with additional use of etanercept. Etanercept at a dose of 50\u2009mg weekly was partially effective but could not reduce the dose of concomitant betamethasone from 5\u2009mg\/day. Etanercept at a dose of 75\u2009mg weekly could lead her to clinical remission and enabled successful tapering off the corticosteroids and discontinuation of etanercept. Normalization of serum C-reactive protein and interleukin 6 and persistent elevation of serum tumor necrosis factor<jats:italic>\u03b1<\/jats:italic>under the treatment with high-dose corticosteroids and immunosuppressants suggest that tumor necrosis factor<jats:italic>\u03b1<\/jats:italic>was more deeply involved than at least interleukin 6 in the pathogenesis of refractoriness of the disease in this patient, and these findings might be indicative of potential efficacy for adjunctive use of a tumor necrosis factor inhibitor rather than an interleukin 6 inhibitor.<\/jats:p>","DOI":"10.1155\/2013\/923497","type":"journal-article","created":{"date-parts":[[2013,12,17]],"date-time":"2013-12-17T16:04:55Z","timestamp":1387296295000},"page":"1-4","source":"Crossref","is-referenced-by-count":1,"title":["Successful Use of Higher-Dose Etanercept for Multirefractory Systemic Flare of Adult-Onset Still\u2019s Disease with Liver Failure with No Response to Tocilizumab 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