Managing Still's Disease: EULAR/PReS Recommendations and Complications

🔑 The new recommendations for Still's disease include giving it a single name, which will have a significant impact on clinical practice and clinical trials.

⏳ The prevalence of Still's disease is higher in patients under 35 years old, with more severe manifestations seen in younger patients, particularly those under 18 months old.

🔄 The unification of Still's disease as a single condition was possible due to a systematic review that showed the similarities in symptoms between adult-onset and pediatric-onset cases.

🔑 The treatment for Still's disease involves shared decision-making between the doctor and the patient, with specific targets for treatment.

📋 Active monitoring of the patient is important, especially for the potentially severe complication of macrophage activation syndrome.

💡 The recommendations for Still's disease include early diagnosis based on key clinical manifestations and laboratory abnormalities.

⭐ Doença de Still has characteristic clinical features including maculopapular rash, arthralgia or myalgia, and elevated levels of certain inflammatory markers.

🔬 Diagnostic criteria for Doença de Still include the Amaguchi criteria and the use of additional markers such as IL1 and s100 proteins.

💊 Treatment goals for Doença de Still include achieving clinical inactivity and remission, with specific targets at different time points in the treatment.

🔑 The treatment of Still's disease involves aggressive management to achieve clinical remission and minimize the use of corticosteroids.

💊 Recommended treatments for Still's disease include anti-inflammatory drugs as a temporary solution, corticosteroids as an effective therapy, and biologics such as IL-1 and IL-6 inhibitors as the preferred options.

⏰ Early initiation of treatment is crucial for better clinical response, with a higher success rate observed when treatment is started within 1 to 6 months of symptom onset.

🔑 The recommendations for treating Still's disease include individualizing treatment based on clinical context and potentially overtreating to avoid morbidity and mortality.

👀 Complications to watch out for in Still's disease include macrophage activation syndrome and pulmonary involvement.

💉 In cases of Still's disease complicated by macrophage activation syndrome, higher doses of corticosteroids and interleukin-1 inhibitors may be necessary.

⭐️ The recommended first-line treatment for Still's disease in Brazil is corticosteroids and ciclosporin.

🌬️ Screening for pulmonary manifestations in Still's disease should be done actively in both children and adults, with imaging and pulmonary function tests.

🫁 Interstitial lung disease is a common complication in patients with long-standing Still's disease, and specific targeted medications may be considered.

⭐️ Patients with difficult-to-treat Still's Disease should be referred to specialized centers with expertise in the disease.

✔️ Aggressive treatment is recommended, with the use of specific medications and defined therapeutic targets.

🔬 Upcoming recommendations may provide easier access to medications and improve patient care.

⚠️ Early treatment is crucial to prevent complications and long-term joint damage.