Systemic juvenile idiopathic arthritis and adult-onset Still's disease should be grouped into one disease, Still's disease, according to new diagnosis and treatment recommendations presented at EULAR2023
and adult-onset Still's disease should be grouped into one disease, Still's disease, according to new diagnosis and treatment recommendations presented at the European Alliance of Associations for Rheumatology 2023 Annual Meeting.
To diagnose and treat Still's disease, the recommendations state that clinicians should consider four criteria:A transient rash, preferentially on the trunk, that coincides with fever spikes, rash is typically erythematous but other rashes, likeSome musculoskeletal involvement is common, involving arthralgia/myalgia
For individuals with suspected Still's disease, nonsteroidal anti-inflammatory drugs can be used as a"bridging therapy" before the diagnosis is confirmed.The recommendations emphasized that treatment and therapeutic strategy"should be based on shared decision making between the parents/patients and the treating team," with the ultimate goal of drug-free remission.
for sJIA, noted Karen Onel, MD, pediatric rheumatologist, Hospital for Special Surgery, New York City, and the principle investigator for the ACR guidelines. One main difference is that the EULAR recommendations included timelines for treatment targets, while the ACR's did not., though there are still some unknowns."We don't actually know what the tapering frequency should be," she said,"but these are definitely goals that we need to explore and see how they evolve.
The recommendations also addressed the risk for lung disease,"which is an emerging issue, particularly in children, that the physician should be very well aware of," De Benedetti said. This complication can arise at any time point of the disease, he added.
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