Loading Curie Briefs...
Getting the latest healthcare news for you
Getting the latest healthcare news for you
Starting with biologics beats traditional options in Still disease. A two-center cohort study found that patients with adult-onset Still disease (AOSD) who received first-line biologic therapy — like anakinra or tocilizumab — achieved significantly higher rates of sustained remission at 72 weeks compared to methotrexate, calcineurin inhibitors, or JAK inhibitors. Biologics also helped more patients discontinue long-term steroids.
A "top-down" treatment approach is gaining traction for adult-onset Still disease (AOSD), a rare and serious inflammatory condition. A retrospective, propensity-weighted cohort study of 124 patients across centers in China and Germany found that starting with biologic therapy — specifically anakinra or tocilizumab — led to significantly better outcomes than conventional options like methotrexate (MTX), calcineurin inhibitors (CNI), or JAK inhibitors over 72 weeks.
Patients on first-line biologics were more likely to achieve sustained event-free remission and were also more successful in discontinuing long-term glucocorticoids (steroids) — a meaningful benefit given the well-known risks of prolonged steroid use.
By the Numbers:
Why it matters: AOSD is rare but debilitating, and treatment decisions are often made without strong evidence. This study supports reconsidering the traditional "step-up" approach — initiating the most effective therapy first could spare patients from prolonged disease activity and steroid dependence. Prospective trials are still needed to confirm these findings.
