{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T00:49:36Z","timestamp":1760057376607,"version":"build-2065373602"},"reference-count":52,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T00:00:00Z","timestamp":1738627200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Novartis Pharma GmbH and Swedish Orphan Biovitrium GmbH (Sobi)"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Adult-onset Still\u2019s disease (AOSD) is an autoinflammatory disorder that can be challenging to diagnose and manage. The aim of this study was to analyze retrospective data to provide insights into the clinical presentation, disease activity, and treatment patterns and outcomes of AOSD during routine clinical care prior to the release of new AOSD guidelines. Methods: This retrospective database analysis evaluated adult patients (\u226518 years) with a diagnosis of AOSD who engaged in a clinical visit between 1 January 2010 and 31 December 2020. The evaluated outcomes included demographic characteristics, symptoms, disease activity, and treatment. Results: Our study included 120 patients (67 [55.8%] of whom were female) diagnosed with AOSD according to the Yamaguchi criteria at ten German rheumatology centers. The median (quartile [Q] 1, Q3) age was 51 (36, 62) years, and the median (Q1, Q3) time from diagnosis was 9 (4, 11) years. Approximately half (66 [55.0%]) had a polycyclic disease course. The most frequent symptoms at initial diagnosis were arthralgia (105 [87.5%]) and fever (86 [71.7%]), and these symptoms continued for a substantial proportion of patients at the current visit (35 [29.2%] and 22 [18.3%], respectively). High neutrophil and ferritin levels were also common. The mean Still Activity Score, a measure of disease activity, improved from 4.66 at initial diagnosis to 1.97 at the most recent visit. The treatments most frequently used at some point in the disease course were glucocorticoids (118 [98.3%]), interleukin (IL)-1 inhibitors (89 [74.2%]), and methotrexate (85 [70.8%]). The most common current treatments were IL-1 inhibitors (55 [45.8%]), followed by methotrexate (29 [24.2%}) and glucocorticoids (28 [23.3%]). Conclusions: Our cohort of patients with AOSD seen at German rheumatology clinics showed strong improvements in symptoms and disease activity from initial diagnosis, but a high symptom burden remained for some patients. Future studies may be able to build on our data to document the impact of new guidelines on treatment patterns.<\/jats:p>","DOI":"10.3390\/jcm14030981","type":"journal-article","created":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T05:55:22Z","timestamp":1738648522000},"page":"981","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Patients with Adult-Onset Still\u2019s Disease in Germany: A Retrospective Analysis of Clinical Characteristics and Treatment Practices Ahead of the Release of the German Recommendations"],"prefix":"10.3390","volume":"14","author":[{"given":"Verena","family":"Schoenau","sequence":"first","affiliation":[{"name":"Department of Internal Medicine 3\u2014Rheumatology and Immunology, Friedrich-Alexander University (FAU) Erlangen-N\u00fcrnberg and Universit\u00e4tsklinikum Erlangen, 91054 Erlangen, Germany"},{"name":"Deutsches Zentrum Immuntherapie, Friedrich-Alexander University (FAU) Erlangen-N\u00fcrnberg and Universit\u00e4tsklinikum Erlangen, 91054 Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Wendel","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Clinical Immunology, Medical Center\u2014University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg im Breisgau, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koray","family":"Tascilar","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine 3\u2014Rheumatology and Immunology, Friedrich-Alexander University (FAU) Erlangen-N\u00fcrnberg and Universit\u00e4tsklinikum Erlangen, 91054 Erlangen, Germany"},{"name":"Deutsches Zentrum Immuntherapie, Friedrich-Alexander University (FAU) Erlangen-N\u00fcrnberg and Universit\u00e4tsklinikum Erlangen, 91054 Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8385-6861","authenticated-orcid":false,"given":"Joerg","family":"Henes","sequence":"additional","affiliation":[{"name":"Centre for Interdisciplinary Clinical Immunology, Rheumatology and Auto-inflammatory Diseases, Department of Internal Medicine II (Oncology, Haematology, Immunology and Rheumatology), Universitatsklinikum T\u00fcbingen, 72074 T\u00fcbingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9872-5282","authenticated-orcid":false,"given":"Eugen","family":"Feist","sequence":"additional","affiliation":[{"name":"Helios Clinic Vogelsang-Gommern, Department for Rheumatology and Clinical Immunology & Experimental Rheumatology, Otto-von-Guericke-University, 39106 Magdeburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Niklas Thomas","family":"Baerlecken","sequence":"additional","affiliation":[{"name":"Private Practice Rheumatology, 50996 Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Florian","family":"Popp","sequence":"additional","affiliation":[{"name":"MVZ for Rheumatology Dr. M. Welcker, 82152 Planegg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthias","family":"Schmidt-Haendle","sequence":"additional","affiliation":[{"name":"Rheumapraxis Bayreuth, 95444 Bayreuth, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernhard","family":"Hellmich","sequence":"additional","affiliation":[{"name":"Medius Kliniken, Department of Internal Medicine, Rheumatology, Pulmonology, Nephrology and Diabetology, University of T\u00fcbingen, 73230 Kirchheim-Teck, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ina","family":"K\u00f6tter","sequence":"additional","affiliation":[{"name":"University Hospital Hamburg-Eppendorf, 20246 Hamburg, Germany"},{"name":"Clinic for Rheumatology and Immunology, 24576 Bad Bramstedt, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8007-9905","authenticated-orcid":false,"given":"Ioana","family":"Andreica","sequence":"additional","affiliation":[{"name":"Rheumatology, Ruhr-Universit\u00e4t Bochum, 44801 Bochum, Germany"},{"name":"Rheumazentrum Ruhrgebiet, 44649 Herne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00fcrgen","family":"Rech","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine 3\u2014Rheumatology and Immunology, Friedrich-Alexander University (FAU) Erlangen-N\u00fcrnberg and Universit\u00e4tsklinikum Erlangen, 91054 Erlangen, Germany"},{"name":"Deutsches Zentrum Immuntherapie, Friedrich-Alexander University (FAU) Erlangen-N\u00fcrnberg and Universit\u00e4tsklinikum Erlangen, 91054 Erlangen, Germany"},{"name":"Center for Rare Diseases Erlangen (ZSEER), Friedrich-Alexander University (FAU) Erlangen-N\u00fcrnberg and Universit\u00e4tsklinikum Erlangen, 91054 Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1614","DOI":"10.1136\/ard-2024-225851","article-title":"EULAR\/PReS recommendations for the diagnosis and management of Still\u2019s disease, comprising systemic juvenile idiopathic arthritis and adult-onset Still\u2019s disease","volume":"83","author":"Fautrel","year":"2024","journal-title":"Ann. Rheum. Dis."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1748","DOI":"10.1136\/ard-2024-225853","article-title":"Systemic juvenile idiopathic arthritis and adult-onset Still\u2019s disease are the same disease: Evidence from systematic reviews and meta-analyses informing the 2023 EULAR\/PReS recommendations for the diagnosis and management of Still\u2019s disease","volume":"83","author":"Bindoli","year":"2024","journal-title":"Ann. Rheum. Dis."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1016\/j.autrev.2014.01.058","article-title":"Adult-onset Still\u2019s disease","volume":"13","author":"Jamilloux","year":"2014","journal-title":"Autoimmun. Rev."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"721","DOI":"10.2169\/internalmedicine.3727-19","article-title":"Elderly-onset Still\u2019s disease complicated by macrophage activation syndrome: A case report and review of the literature","volume":"59","author":"Suda","year":"2020","journal-title":"Intern. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"152264","DOI":"10.1016\/j.semarthrit.2023.152264","article-title":"Burden of adult-onset Still\u2019s disease: A systematic review of health-related quality of life, utilities, costs and resource use","volume":"63","author":"Ruscitti","year":"2023","journal-title":"Semin. Arthritis Rheum."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Mittal, S., Schroeder, B., and Alfaki, M. (2024). Mortality, length of stay and cost of hospitalization among patients with adult-onset Still\u2019s disease: Results from the National Inpatient Sample 2016-2019. Diseases, 12.","DOI":"10.3390\/diseases12070166"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1136\/ard.30.2.121","article-title":"Still\u2019s disease in the adult","volume":"30","author":"Bywaters","year":"1971","journal-title":"Ann. Rheum. Dis."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Tomaras, S., Goetzke, C.C., Kallinich, T., and Feist, E. (2021). Adult-onset Still\u2019s disease: Clinical aspects and therapeutic approach. J. Clin. Med., 10.","DOI":"10.3390\/jcm10040733"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1118","DOI":"10.3899\/jrheum.130575","article-title":"Interleukin 18: A biomarker for differential diagnosis between adult-onset Still\u2019s disease and sepsis","volume":"41","author":"Priori","year":"2014","journal-title":"J. Rheumatol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1038\/s41584-018-0081-x","article-title":"Mechanisms, biomarkers and targets for adult-onset Still\u2019s disease","volume":"14","author":"Feist","year":"2018","journal-title":"Nat. Rev. Rheumatol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1007\/s00393-020-00779-2","article-title":"Das Still-Syndrom als biphasische Erkrankung: Aktuelle Erkenntnisse zur Pathogenese und neue therapeutische Ans\u00e4tze [Still\u2019s disease as biphasic disorder: Current knowledge on pathogenesis and novel treatment approaches]","volume":"79","author":"Wittkowski","year":"2020","journal-title":"Z. Rheumatol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1002\/art.1780300209","article-title":"Adult-onset Still\u2019s disease. Clinical course and outcome","volume":"30","author":"Cush","year":"1987","journal-title":"Arthritis Rheum."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"858","DOI":"10.1016\/j.semarthrit.2021.06.004","article-title":"Adult-onset Still\u2019s disease in focus: Clinical manifestations, diagnosis, treatment, and unmet needs in the rra of targeted therapies","volume":"51","author":"Efthimiou","year":"2021","journal-title":"Semin. Arthritis Rheum."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Jung, J.Y., Kim, J.W., Suh, C.H., and Kim, H.A. (2020). Roles of interactions between toll-like receptors and their endogenous ligands in the pathogenesis of systemic juvenile idiopathic arthritis and adult-onset Still\u2019s disease. Front. Immunol., 11.","DOI":"10.3389\/fimmu.2020.583513"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1405","DOI":"10.1002\/art.38615","article-title":"Review: Is there a window of opportunity for treatment of systemic juvenile idiopathic arthritis?","volume":"66","author":"Nigrovic","year":"2014","journal-title":"Arthritis Rheumatol."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Friedrich, R., Kernder, A., Blank, N., Ernst, D., Henes, J., Key\u00dfer, G., Klemm, P., Krusche, M., Meinecke, A., and Rech, J. (Z. Rheumatol., 2024). Implementation of the new DGRh S2e guideline on diagnostics and treatment of adult-onset Still\u2019s disease in Germany. Implications for clinical practice in rheumatology, Z. Rheumatol., Epub ahead of print.","DOI":"10.1007\/s00393-024-01607-7"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1097\/01.md.0000188009.47085.76","article-title":"Adult-onset Still disease as the cause of fever of unknown origin","volume":"84","author":"Crispin","year":"2005","journal-title":"Medicine"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1007\/s12688-019-00292-8","article-title":"Makrophagenaktivierungssyndrom\u2014Eine seltene Komplikation bei adultem Morbus Still","volume":"19","author":"Sautner","year":"2020","journal-title":"Rheuma Plus"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1007\/s00393-011-0859-6","article-title":"Adulter Morbus Still, Fieber, Diagnose und Therapie [Adult onset Still\u2019s disease, fever, diagnosis and therapy]","volume":"71","author":"Baerlecken","year":"2012","journal-title":"Z. Rheumatol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"428","DOI":"10.2177\/jsci.30.428","article-title":"Macrophage activation syndrome associated with adult-onset Still\u2019s disease","volume":"30","author":"Iwamoto","year":"2007","journal-title":"Nihon Rinsho Meneki Gakkai Kaishi"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1333","DOI":"10.1007\/s10067-015-2923-0","article-title":"Macrophage activation syndrome in the course of monogenic autoinflammatory disorders","volume":"34","author":"Rigante","year":"2015","journal-title":"Clin. Rheumatol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1722","DOI":"10.1136\/annrheumdis-2019-216040","article-title":"Emergent high fatality lung disease in systemic juvenile arthritis","volume":"78","author":"Saper","year":"2019","journal-title":"Ann. Rheum. Dis."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1152","DOI":"10.1136\/annrheumdis-2020-218048","article-title":"Lung involvement in macrophage activation syndrome and severe COVID-19: Results from a cross-sectional study to assess clinical, laboratory and artificial intelligence-radiological differences","volume":"79","author":"Ruscitti","year":"2020","journal-title":"Ann. Rheum. Dis."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Chantarogh, S., Vilaiyuk, S., Tim-Aroon, T., and Worawichawong, S. (2017). Clinical improvement of renal amyloidosis in a patient with systemic-onset juvenile idiopathic arthritis who received tocilizumab treatment: A case report and literature review. BMC Nephrol., 18.","DOI":"10.1186\/s12882-017-0573-y"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1097\/00005792-199103000-00004","article-title":"Adult Still\u2019s disease: Manifestations, disease course, and outcome in 62 patients","volume":"70","author":"Pouchot","year":"1991","journal-title":"Medicine"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2369","DOI":"10.3899\/jrheum.100247","article-title":"Clinical manifestations but not cytokine profiles differentiate adult-onset Still\u2019s disease and sepsis","volume":"37","author":"Rau","year":"2010","journal-title":"J. Rheumatol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"105499","DOI":"10.1016\/j.jbspin.2022.105499","article-title":"Derivation and validation of adult Still Activity Score (SAS)","volume":"90","author":"Kalyoncu","year":"2023","journal-title":"Jt. Bone Spine"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1731","DOI":"10.1136\/ard-2024-225854","article-title":"Efficacy and safety of therapies for Still\u2019s disease and macrophage activation syndrome (MAS): A systematic review informing the EULAR\/PReS guidelines for the management of Still\u2019s disease","volume":"83","author":"Bindoli","year":"2024","journal-title":"Ann. Rheum. Dis."},{"key":"ref_29","first-page":"0402","article-title":"Reporting of clinical features and outcome measures in Still\u2019s disease: A systematic literature review of sJIA and AOSD cohorts [abstract]","volume":"76","author":"Bracaglia","year":"2024","journal-title":"Arthritis Rheumatol."},{"key":"ref_30","first-page":"2030","article-title":"The development of the EULAR Score for the definition of disease activity in adult-onset Still\u2019s sisease; The \u201cDAVID\u201d Project [abstract]","volume":"76","author":"Ruscitti","year":"2024","journal-title":"Arthritis Rheumatol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1656","DOI":"10.1093\/rheumatology\/kead461","article-title":"Management of adult-onset Still\u2019s disease: Evidence- and consensus-based recommendations by experts","volume":"63","author":"Leavis","year":"2024","journal-title":"Rheumatology"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s00393-022-01276-4","article-title":"DGRh-S2e-Leitlinie: Diagnostik und Therapie des adulten Still-Syndroms (AOSD)","volume":"81","author":"Feist","year":"2022","journal-title":"Z. Rheumatol."},{"key":"ref_33","first-page":"424","article-title":"Preliminary criteria for classification of adult Still\u2019s disease","volume":"19","author":"Yamaguchi","year":"1992","journal-title":"J. Rheumatol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"578","DOI":"10.1016\/j.semarthrit.2017.07.005","article-title":"Validation of the Fautrel Classification Criteria for Adult-Onset Still\u2019s Disease","volume":"47","author":"Lebrun","year":"2018","journal-title":"Semin. Arthritis Rheum."},{"key":"ref_35","first-page":"41","article-title":"Adult onset Still\u2019s disease: Clinical presentation in a large cohort of Italian patients","volume":"28","author":"Franchini","year":"2010","journal-title":"Clin. Exp. Rheumatol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.jaut.2016.02.010","article-title":"Response rate of initial conventional treatments, disease course, and related factors of patients with adult-onset Still\u2019s disease: Data from a large multicenter cohort","volume":"69","author":"Kalyoncu","year":"2016","journal-title":"J. Autoimmun."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"4124","DOI":"10.1093\/rheumatology\/keac027","article-title":"Disparities in the prevalence of clinical reatures between systemic juvenile idiopathic arthritis and adult-onset Still\u2019s disease","volume":"61","author":"Ruscitti","year":"2022","journal-title":"Rheumatology"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"152139","DOI":"10.1016\/j.semarthrit.2022.152139","article-title":"Systematic review on the use of biologics in adult-onset Still\u2019s disease","volume":"58","author":"Fautrel","year":"2023","journal-title":"Semin. Arthritis Rheum."},{"key":"ref_39","unstructured":"European Medicines Agency (2024, November 21). Summary of Opinion (Post Authorization): Ilaris (Canakinumab). 23 June 2016. Available online: https:\/\/www.ema.europa.eu\/en\/documents\/smop\/chmp-post-authorisation-summary-positive-opinion-ilaris_en.pdf-1."},{"key":"ref_40","unstructured":"Sobi (2024, November 21). Kineret\u00ae (anakinra) approved in the EU for the treatment of Still\u2019s disease. 11 April 2018. Available online: https:\/\/www.sobi.com\/sites\/sobi\/files\/pr\/201804107653-1.pdf."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Kernder, A., Filla, T., Friedrich, R., Blank, N., Ernst, D., Henes, J., Key\u00dfer, G., Klemm, P., Krusche, M., and Meinecke, A. (Lancet Rheum., 2025). First-line biological vs. conventional therapy in adult-onset Still\u2019s disease: A multicentre, retrospective, propensity weighted analysis, Lancet Rheum., Manuscript accepted.","DOI":"10.2139\/ssrn.5042366"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Ursini, F., Gregg, E., Canon-Garcia, V., Rabijns, H., Toennessen, K., Bartlett, K., and Graziadio, S. (2023). Care pathway analysis and evidence gaps in adult-onset Still\u2019s disease: Interviews with experts from the UK, France, Italy, and Germany. Front. Med., 10.","DOI":"10.3389\/fmed.2023.1257413"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1186\/s12969-018-0224-2","article-title":"PRO-KIND SJIA project collaborators. Practice and consensus-based strategies in diagnosing and managing systemic juvenile idiopathic arthritis in Germany","volume":"16","author":"Hinze","year":"2018","journal-title":"Pediatr. Rheumatol. Online J."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1136\/annrheumdis-2018-213030","article-title":"Treating juvenile idiopathic arthritis to target: Recommendations of an international task force","volume":"77","author":"Ravelli","year":"2018","journal-title":"Ann. Rheum. Dis."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"497","DOI":"10.3899\/jrheum.210709","article-title":"Consensus approach to a treat-to-target strategy in juvenile idiopathic arthritis care: Report From the 2020 PR-COIN Consensus Conference","volume":"49","author":"Ryan","year":"2022","journal-title":"J. Rheumatol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1002\/art.42037","article-title":"2021 American College of Rheumatology guideline for the treatment of juvenile idiopathic arthritis: Therapeutic approaches for oligoarthritis, temporomandibular joint arthritis, and systemic juvenile idiopathic arthritis","volume":"74","author":"Onel","year":"2022","journal-title":"Arthritis Rheumatol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1163","DOI":"10.1002\/art.40865","article-title":"Treatment to target using recombinant interleukin-1 receptor antagonist as first-line monotherapy in new-onset systemic juvenile idiopathic arthritis: Results from a five-year follow-up study","volume":"71","author":"Swart","year":"2019","journal-title":"Arthritis Rheumatol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"969","DOI":"10.1136\/annrheumdis-2019-216843","article-title":"Treat-to-target study for improved outcome in polyarticular juvenile idiopathic arthritis","volume":"79","author":"Klein","year":"2020","journal-title":"Ann. Rheum. Dis."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"2402","DOI":"10.1093\/rheumatology\/kez615","article-title":"Clinical and associated inflammatory biomarker features predictive of short-term outcomes in non-systemic juvenile idiopathic arthritis","volume":"59","author":"Rezaei","year":"2020","journal-title":"Rheumatology"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"e004317","DOI":"10.1136\/rmdopen-2024-004317","article-title":"Nordic Study Group of Paediatric Rheumatology (NoSPeR). Inflammatory biomarkers predicting long-term remission and active disease in juvenile idiopathic arthritis: A population-based study of the Nordic JIA cohort","volume":"10","author":"Glerup","year":"2024","journal-title":"RMD Open"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"vi9","DOI":"10.1093\/rheumatology\/kez350","article-title":"Anakinra in children and adults with Still\u2019s disease","volume":"58","author":"Vastert","year":"2019","journal-title":"Rheumatology"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1007\/s40265-024-01993-x","article-title":"Adult-onset Still\u2019s disease (AOSD): Advances in understanding pathophysiology, genetics and emerging treatment options","volume":"84","author":"Bindoli","year":"2024","journal-title":"Drugs"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/3\/981\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:26:27Z","timestamp":1760027187000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/3\/981"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,4]]},"references-count":52,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,2]]}},"alternative-id":["jcm14030981"],"URL":"https:\/\/doi.org\/10.3390\/jcm14030981","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2025,2,4]]}}}