Therapeutic response of patients with adult Still's disease to biologic agents: multicenter results in Japan

Mod Rheumatol. 2012 Sep;22(5):712-9. doi: 10.1007/s10165-011-0569-6. Epub 2011 Dec 9.


Objective: The efficacy of biologics in treating adult Still's disease (ASD) is suggested, but the information is still lacking and the validation is insufficient. To determine the efficacy of several biologic agents in refractory ASD in Japan, a multicenter survey was performed.

Method: Clinical data on 16 ASD patients who had been treated with at least 1 of the biological agents (total 24 occasions) were collected retrospectively.

Results: Infliximab was used in 9 cases, etanercept in 4, and tocilizumab in 11. Half of the patients that had been treated initially with infliximab or etanercept were changed to another biologics. Tocilizumab was effective in cases switched from another 2 drugs. Tocilizumab showed efficacy in treating both systemic and arthritic symptoms and showed apparent steroid-sparing effect and the highest continuation rate.

Conclusion: Tocilizumab may be a promising biologic agent in refractory ASD.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Antibodies, Monoclonal / therapeutic use*
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Antirheumatic Agents / therapeutic use*
  • C-Reactive Protein / analysis
  • Child
  • Drug Substitution
  • Etanercept
  • Female
  • Ferritins / blood
  • Humans
  • Immunoglobulin G / therapeutic use
  • Infliximab
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Receptors, Tumor Necrosis Factor / therapeutic use
  • Retrospective Studies
  • Still's Disease, Adult-Onset / blood
  • Still's Disease, Adult-Onset / drug therapy*
  • Treatment Outcome
  • Young Adult


  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Antirheumatic Agents
  • Immunoglobulin G
  • Receptors, Tumor Necrosis Factor
  • C-Reactive Protein
  • Ferritins
  • Infliximab
  • tocilizumab
  • Etanercept