Managing Still's Disease: EULAR/PReS Recommendations and Complications
The video discusses the EULAR/PReS recommendations for the treatment of Still's disease, emphasizing individualized treatment and mentioning complications such as macrophage activation syndrome and pulmonary involvement.
00:00:00 The episode discusses the new recommendations for Still's disease, including changes in terminology and the prevalence of symptoms. It also covers the treatment options for the disease.
🔑 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.
00:04:25 In this Reumatize Podcast episode, recommendations for the diagnosis and treatment of Still's disease are discussed, emphasizing the importance of early diagnosis and treatment. Key symptoms include persistent fever, evanescent rash, and musculoskeletal manifestations.
🔑 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.
00:08:51 Essential recommendations for the diagnosis and treatment of Still's disease, focusing on clinical characteristics, laboratory findings, diagnostic criteria, and therapeutic goals.
⭐ 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.
00:13:17 The video discusses the recommendations for the treatment of Still's disease, emphasizing the importance of early and effective treatment with low-dose corticosteroids and biologics such as IL-1 and IL-6 inhibitors. Starting treatment early increases the likelihood of remission.
🔑 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.
00:17:42 Summary: The video discusses the EULAR/PReS recommendations for the treatment of Still's disease, emphasizing the individualization of treatment based on clinical context. Complications such as macrophage activation syndrome and pulmonary involvement are highlighted. The use of scoring systems for diagnosis and the use of higher doses of corticosteroids and interleukin 1 inhibitors in patients with macrophage activation syndrome are also mentioned.
🔑 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.
00:22:08 This episode of Reumatize Podcast discusses recommendations for the management of Still's disease, including the use of corticosteroids and cyclosporine. It also addresses the complications of pulmonary involvement and the potential association with biologic medications.
⭐️ 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.
00:26:33 Recommendations for the treatment of Still's disease include referral to specialized centers and aggressive treatment with defined therapeutic targets, such as IL-1 and IL-6 inhibitors. These recommendations aim to improve patient care and access to medications.
⭐️ 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.
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