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Therapeutic responses and prognosis in adult-onset Still's disease.

机译:成人发病斯蒂尔病的治疗反应和预后。

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To date, the treatment of adult-onset Still's disease (AOSD) has been largely empirical; therefore, this study was conducted to investigate the response to therapy and prognostic factors of AOSD. Fifty-four Korean patients with AOSD were enrolled based on Yamaguchi's criteria. We retrospectively analyzed the treatments and prognosis. Thirty-nine patients (72.2) were female, and the average age at disease onset was 37.3 years. Twenty-nine patients had a monocyclic disease (53.7), five had a polycyclic (9.3) and fifteen had a chronic articular disease (27.7) and five died (9.3). The elevated ESR and corticosteroids refractoriness were associated with poor prognosis (P = 0.023 and P = 0.009, respectively). The patients that died were older than those survived (49.2 ± 11.8 vs. 42.2 ± 14 year old, P = 0.024). Forty-two patients were treated with non-steroidal anti-inflammatory drugs; however, they also needed corticosteroids and intravenous immunoglobulin (IVIG). Among 50 patients treated with high-dose corticosteroids, 21 patients (42) were resistant to corticosteroids and treated with IVIG or anti-tumor necrosis factor (TNF) agents. Of the 23 patients medicated with IVIG, the prognosis was better in IVIG-responsive patients, indicating a therapeutic effect. Methotrexate was the most commonly used disease modifying anti-rheumatic drugs (27 patients, 50), and the corticosteroid requirements were lower in the methotrexate-responsive patients. Approximately half of AOSD patients had a poor prognosis and were corticosteroids resistance. An elevated ESR and non-response to corticosteroids were associated with poor prognosis. Patients who died were older than those survived.
机译:迄今为止,成人发病的斯蒂尔病 (AOSD) 的治疗在很大程度上是经验性的;因此,本研究旨在调查 AOSD 的治疗反应和预后因素。根据 Yamaguchi 的标准招募了 54 名韩国 AOSD 患者。我们回顾性分析了治疗和预后。39例(72.2%)为女性,平均发病年龄为37.3岁。29例为单环病(53.7%),5例为多环病(9.3%),15例为慢性关节病(27.7%),5例死亡(9.3%)。ESR和皮质类固醇难治性升高与不良预后相关(分别为P=0.023和P=0.009)。死亡患者的年龄大于存活的患者(49.2 ± 11.8 vs 42.2 ± 14 岁,P = 0.024)。42例患者接受非甾体抗炎药治疗;然而,他们还需要皮质类固醇和静脉注射免疫球蛋白 (IVIG)。在接受大剂量皮质类固醇治疗的 50 例患者中,21 例 (42%) 患者对皮质类固醇耐药并接受 IVIG 或抗肿瘤坏死因子 (TNF) 药物治疗。在接受IVIG药物治疗的23例患者中,IVIG反应患者的预后较好,表明有治疗效果。甲氨蝶呤是最常用的疾病修饰抗风湿药物(27例,50%),甲氨蝶呤反应患者皮质类固醇需求量较低。大约一半的AOSD患者预后不良,并且对皮质类固醇有抵抗力。红细胞沉降率升高和对皮质类固醇无反应与预后不良有关。死亡的患者比幸存者年龄大。

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