The administration of methotrexate in patients with Still's disease, “real-life” findings from AIDA Network Still Disease Registry

Ruscitti, P.; Sota, J.; Vitale, A.; Lopalco, G.; Iannone, F.; Morrone, M.; Giardini, H. A. M.; D'Agostin, M. A.; Antonelli, I. P. D. B.; Almaghlouth, I.; Asfina, K. N.; Khalil, N.; Sfikakis, P. P.; Laskari, K.; Tektonidou, M.; Ciccia, F.; Iacono, D.; Riccio, F.; Ragab, G.; Hussein, M. A.; Govoni, M.; Ruffilli, F.; Direskeneli, H.; Alibaz-Oner, F.; Giacomelli, R.; Navarini, L.; Bartoloni, E.; Riccucci, I.; Martin-Nares, E.; Torres-Ruiz, J.; Cipriani, P.; Di Cola, I.; Hernandez-Rodriguez, J.; Gomez-Caverzaschi, V.; Dagna, L.; Tomelleri, A.; Makowska, J.; Brzezinska, O.; Iagnocco, A.; Bellis, E.; Caggiano, V.; Gaggiano, C.; Tarsia, M.; Mormile, I.; Emmi, G.; Sfriso, P.; Monti, S.; Erten, S.; Del Giudice, E.; Lubrano, R.; Conti, G.; Olivieri, A. N.; Lo Gullo, A.; Tharwat, S.; Karamanakos, A.; Gidaro, A.; Maggio, M. C.; La Torre, F.; Cardinale, F.; Ogunjimi, B.; Maier, A.; Sebastiani, G. D.; Opris-Belinski, D.; Frassi, M.; Viapiana, O.; Bizzi, E.; Carubbi, F.; Fotis, L.; Tufan, A.; Kardas, R. C.; Wiesik-Szewczyk, E.; Jahnz-Rozyk, K.; Fabiani, C.; Frediani, B.; Balistreri, A.; Rigante, D.; Cantarini, L.

doi:10.1016/j.semarthrit.2023.152244

Objectives: To describe clinical characteristics of patients with Still's disease treated with methotrexate (MTX) and to assess drug effectiveness evaluating change in disease activity, reduction of inflammatory markers, and glucocorticoid (GC)-sparing effect. Methods: Patients with Still's disease treated with MTX were assessed among those included in AIDA Network Still Disease Registry. Results: In this registry, 171 patients with Still's disease were treated with MTX (males 43.3%, age 37.1 ± 16.0 years). They were mainly characterised by joint features and fever without a prominent multiorgan involvement. MTX was administered with GCs in 68.4% of patients, with other conventional synthetic DMARDs in 6.4%, and with biologic DMARDs in 25.1%. A significant reduction of the modified systemic score was observed, and 38.6% patients were codified as being in clinical remission at the end of follow-up. The concomitant administration of a biologic DMARD resulted a predictor of the clinical remission. Furthermore, a reduction of inflammatory markers and ferritin levels was observed following the administration of MTX. Additionally, a marked reduction of the dosage of concomitant GCs was identified, while 36.7% discontinued such drugs. Male gender appeared as a predictor of GC discontinuation. MTX was discontinued in 12.3% of patients because of adverse effects, and in 12.3% for lack of efficacy. Conclusions: Clinical characteristics of patients with Still's disease treated with MTX were described, mainly joint features and fever without a prominent multiorgan involvement. The clinical usefulness of MTX was reported in reducing the disease activity, decreasing the inflammatory markers, and as GC-sparing agent.

The administration of methotrexate in patients with Still's disease, “real-life” findings from AIDA Network Still Disease Registry / Ruscitti, P.; Sota, J.; Vitale, A.; Lopalco, G.; Iannone, F.; Morrone, M.; Giardini, H. A. M.; D'Agostin, M. A.; Antonelli, I. P. D. B.; Almaghlouth, I.; Asfina, K. N.; Khalil, N.; Sfikakis, P. P.; Laskari, K.; Tektonidou, M.; Ciccia, F.; Iacono, D.; Riccio, F.; Ragab, G.; Hussein, M. A.; Govoni, M.; Ruffilli, F.; Direskeneli, H.; Alibaz-Oner, F.; Giacomelli, R.; Navarini, L.; Bartoloni, E.; Riccucci, I.; Martin-Nares, E.; Torres-Ruiz, J.; Cipriani, P.; Di Cola, I.; Hernandez-Rodriguez, J.; Gomez-Caverzaschi, V.; Dagna, L.; Tomelleri, A.; Makowska, J.; Brzezinska, O.; Iagnocco, A.; Bellis, E.; Caggiano, V.; Gaggiano, C.; Tarsia, M.; Mormile, I.; Emmi, G.; Sfriso, P.; Monti, S.; Erten, S.; Del Giudice, E.; Lubrano, R.; Conti, G.; Olivieri, A. N.; Lo Gullo, A.; Tharwat, S.; Karamanakos, A.; Gidaro, A.; Maggio, M. C.; La Torre, F.; Cardinale, F.; Ogunjimi, B.; Maier, A.; Sebastiani, G. D.; Opris-Belinski, D.; Frassi, M.; Viapiana, O.; Bizzi, E.; Carubbi, F.; Fotis, L.; Tufan, A.; Kardas, R. C.; Wiesik-Szewczyk, E.; Jahnz-Rozyk, K.; Fabiani, C.; Frediani, B.; Balistreri, A.; Rigante, D.; Cantarini, L.. - In: SEMINARS IN ARTHRITIS AND RHEUMATISM. - ISSN 0049-0172. - 62:(2023), p. 152244. [10.1016/j.semarthrit.2023.152244]