{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T04:52:45Z","timestamp":1793854365391,"version":"4.6.1"},"reference-count":83,"publisher":"The Journal of Rheumatology","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Rheumatol"],"accepted":{"date-parts":[[2024,1,15]]},"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To conduct a systematic review of the effectiveness and safety of pharmacological treatments for adult-onset Still disease (AOSD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Six databases, 2 trial registries, and conference abstracts were searched from January 2012 to February 2023 for studies of pharmacological interventions in people with AOSD. Outcomes were rates of remission and response, discontinuation of concurrent treatments, complications of AOSD, and treatment-related adverse events. Risk of bias was assessed with the Cochrane risk of bias tool and the Joanna Briggs Institute tool for case series.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Forty-four studies evaluated treatments, including nonsteroidal antiinflammatory drugs (NSAIDs), corticosteroids (CS), conventional synthetic disease-modifying antirheumatic drugs (DMARDs), and biologic DMARDs (bDMARDs). For bDMARDs, tocilizumab (TCZ), anakinra (ANK), and canakinumab (CNK) had the most available data. Although 3 randomized controlled trials did not show statistically significant benefits of bDMARDs, metaanalyses showed high rates of complete remission and CS discontinuation. Complete remission was 80% (95% CI 59-92%,\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      36%), 73% (95% CI 58-84%,\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      66%), and 77% (95% CI 29-97%,\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      82%) and CS discontinuation was 57% (95% CI 29-81%,\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      66%), 47% (95% CI 18-78%,\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      79%), and 34% (95% CI 6-81%,\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      59%), respectively, for TCZ, ANK, and CNK. Studies with a higher proportion of patients previously treated with bDMARDs showed a trend toward lower rates of CS discontinuation (\n                      <jats:italic>P<\/jats:italic>\n                      = 0.05). The analyses had high clinical heterogeneity, largely because treatments were prescribed as different lines of therapy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Evidence supports TCZ, ANK, and CNK therapy for AOSD. However, the magnitude of effect and comparative effectiveness of treatments is uncertain.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3899\/jrheum.2023-0995","type":"journal-article","created":{"date-parts":[[2024,2,1]],"date-time":"2024-02-01T08:25:13Z","timestamp":1706775913000},"page":"442-451","source":"Crossref","is-referenced-by-count":19,"title":["Systematic Review and Metaanalysis of Pharmacological Interventions in Adult-Onset Still Disease and the Role of Biologic Disease-Modifying Antirheumatic Drugs"],"prefix":"10.3899","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3487-8551","authenticated-orcid":false,"given":"Piero","family":"Ruscitti","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7715-8226","authenticated-orcid":false,"given":"Dennis","family":"McGonagle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-6628-9595","authenticated-orcid":false,"given":"Viviam Canon","family":"Garcia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-5504-3293","authenticated-orcid":false,"given":"Hilde","family":"Rabijns","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katrin","family":"Toennessen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3789-0727","authenticated-orcid":false,"given":"Mary","family":"Chappell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2071-9990","authenticated-orcid":false,"given":"Mary","family":"Edwards","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Miller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3087-6591","authenticated-orcid":false,"given":"Neil","family":"Hansell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1866-9752","authenticated-orcid":false,"given":"Joe","family":"Moss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Graziadio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9872-5282","authenticated-orcid":false,"given":"Eugen","family":"Feist","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2262","published-online":{"date-parts":[[2024,2,1]]},"reference":[{"key":"2024050105200874000_51.5.442.1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2005.042143"},{"key":"2024050105200874000_51.5.442.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2018.07.018"},{"key":"2024050105200874000_51.5.442.3","doi-asserted-by":"publisher","DOI":"10.1136\/ard.54.7.587"},{"key":"2024050105200874000_51.5.442.4","doi-asserted-by":"crossref","first-page":"393","DOI":"10.3109\/14397595.2014.974881","article-title":"Nationwide epidemiological survey of 169 patients with adult Still\u2019s disease in Japan","volume":"25","author":"Asanuma","year":"2015","journal-title":"Mod Rheumatol"},{"key":"2024050105200874000_51.5.442.5","doi-asserted-by":"publisher","DOI":"10.1080\/03009740510026616"},{"key":"2024050105200874000_51.5.442.6","doi-asserted-by":"crossref","first-page":"250","DOI":"10.26444\/aaem\/132451","article-title":"Adult-onset Still\u2019s disease in Poland \u2013 a nationwide population-based study","volume":"28","author":"Bogdan","year":"2021","journal-title":"Ann Agric Environ Med"},{"key":"2024050105200874000_51.5.442.7","doi-asserted-by":"publisher","DOI":"10.1038\/s41584-018-0081-x"},{"key":"2024050105200874000_51.5.442.8","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 era of targeted therapies","volume":"51","author":"Efthimiou","year":"2021","journal-title":"Semin Arthritis Rheum"},{"key":"2024050105200874000_51.5.442.9","unstructured":"NORD \u2013 National Organization for Rare Disorders . 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