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Adult-onset Still's disease: current challenges and future prospects

Authors Siddiqui M, Putman M, Dua A

Received 3 November 2015

Accepted for publication 31 December 2015

Published 15 March 2016 Volume 2016:8 Pages 17—22

DOI https://doi.org/10.2147/OARRR.S83948

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Abdul Haseeb

Peer reviewer comments 3

Editor who approved publication: Professor Chuan-Ju Liu


Mariam Siddiqui,1 Michael S Putman,2 Anisha B Dua,1

1Department of Rheumatology, 2Department of Internal Medicine, The University of Chicago Medical Center, Chicago, IL, USA

Abstract:
Adult-onset Still's disease (AOSD) – a multi-systemic inflammatory condition characterized by high fevers, polyarthritis, an evanescent rash, and pharyngitis – has been a challenging condition to diagnose expediently and treat effectively. Questions remain regarding the underlying pathophysiology and etiology of AOSD. Pathognomonic diagnostic tests and reliable biomarkers remain undiscovered. Over the past decade, important progress has been made. Diagnostic criteria employing glycosylated ferritin have improved specificity. More important, novel biologic therapies have offered important clues to AOSD's underlying pathophysiology. Cytokine-specific biologic therapies have been instrumental in providing more effective treatment for disease refractory to conventional treatment. While IL-1 therapy has demonstrated efficacy in refractory disease, novel therapies targeting IL-6 and IL-18 show great promise and are currently under investigation.

Keywords: adult-onset Still's disease, biomarkers, therapeutics

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