| Background Adult-onset Still’s disease (AOSD) characterized by a high spiking fever, skin rash, arthritis, and leukocytosis.
The aim of the present study was considering the long-term outcomes of patients with AOSD who were treated with tight
control strategy with disease modifying anti-rheumatic drugs (DMARDs).
Methods Fifty-six patients with AOSD treated with tight control strategy were included. Four levels of remission were
defined. Remission on-treatment was defined as the clinical remission, patient global assessment (PGA) ≤ 1, and prednisolone dose ≤ 5 mg/day for at least 6 months. Remission off-treatment was defined as the clinical remission and PGA≤ 1 for at
least 6 months as well as discontinuation of prednisolone, DMARDs, and biologics. Sustained remission on-treatment was
defined as the clinical remission, PGA ≤1, and prednisolone dose ≤5 mg/day for≥5 years. Sustained remission off-treatment
was defined as the clinical remission and PGA ≤ 1 for ≥ 5 years as well as discontinuation of prednisolone, DMARDs, and
biologics.
Results Throughout a median follow-up of 47 months, remission on-treatment and off-treatment were obtained in 94.6%
and 44.6% of patients, respectively. Sustained remission on-treatment and off-treatment were obtained in 79.2 and 8.3% of
patients, respectively. Glucocorticoids (GCs) and DMARDs were discontinued in 66.1% and 48.2% of the patients, respectively. Apart from the older age of the patients in the on-GCs group, no significant differences were observed between the
groups.
Conclusion Our study showed that using DMARDs with tight control strategy at the presentation of AOSD may control
disease activity successfully |