How do you approach management of Adult Onset Still's disease in a patient with ongoing fatigue and inflammatory joint pain despite methotrexate, colchicine, canakinumab and tocilizumab?

Topics: Rheumatology • General Rheumatology • Autoinflammatory disorders • Adult-onset Still

Heritable autoinflammatory gene testing negative.

Is there a role for TNF inhibitor?

Answer from: at Community Practice

There are several considerations for ongoing inflammatory symptoms despite trials of canakinumab and tocilizumab in a patient with presumed AOSD: If the patient has ongoing CRP elevation, a trial of anakinra might be considered if not previously used. The required daily dosing is not as convenien...

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at Arthritis Associates
I have been faced with this quandry by a couple of...

Answer from: at Academic Institution

Do they actually have arthritis or just joint pain? What do their labs show? I have had AOSD and sJIA patients whose arthritis needs TNF or MTX but their systemic sx still needs IL-1 mediation. But for this patient, I think the important thing to consider is whether this is actually arthritis or som...

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