Still’s Disease
Still’s Disease
• Still’s disease is an autoinflammatory disease,
present in both young children and adults.
• There are 2 different terms used to name it:
• Under 16yrs it is called:
Systemic Juvenile Idiopathic Arthritis SJIA
•
Adults
- Adult-Onset Still’s Disease AOSD
The Disease has the same sign and symptoms
but is differentiated by age of onset.
Systemic juvenile idiopathic arthritis
• This disease was believed to be
idiopathic for a long time.
• Genetic research is underway and
there seems to be innate and
adaptive immune system
involvement.
• There are genetic factors that
influence Still’s disease.
Swelling of Synovial Joints
• Eventual degeneration of the joint
over time.
pathogenesisThe manner of development
Oligoarticular JIA – involves less than 6 joints, and
will be in remission most of the time.
Polyarticular JIA – involves pain & swelling of many
Joints. And involves periodic episodes of
aggravation.
Systemic JIA – involves wide variety to systemic
symptoms - and person must stay on NSAIDs as the
underlying systemic inflammatory never goes away
even when in remission
Enthesitis Associated JIA – inflammation of the
insertion around the joint
Psoriatic JIA – Psoriasis of the skin
Undifferentiated JIA – variety of diff types that don’t
fit into a category
Signs and symptoms
• Periodic fevers
• Skin rashes
• Arthritis
• Painful joints with swelling
• Increased inflammation in body
that shows up in different major
organs such as heart and lungs
• These symptoms taken separately
are all common and can mean
anything from a standard flu virus
to allergies.
Diagnosis
A blood test may to done to rule out
allergies and flu viruses, by looking
at specific inflammatory markers.
The first is an:
-Increase in proinflammatory
cytokine IL-1&6 or Interleukin- 1 and
6
- And raised levels of other
inflammatory markers in the blood:
such as CRP and ESR
• As you can see there is a lot
happening in genetic research to
do with Still’s disease.
Management and
treatment
NSAIDs help deal with joint pain and inflammation
How is Still’s disease
relevant to us a RMT’s
Regular massages can help with the
inflammation, improve fluid build-up and
circulation. Lymphatic massage and petrissage
are two massage techniques that support
chronic inflammatory conditions because they
promotes improved drainage of fluids from the
tissues.
FDA Approves First Treatment for Adult Onset
Still’s Disease, a Severe and Rare Disease
“Prior to today’s approval, patients had no FDA-approved treatments for their disease,
which can include symptoms such as painful arthritis, fevers and rash,” said Nikolay
Nikolov, M.D., acting director of the Division of Rheumatology and Transplant Medicine
in the FDA’s Center for Drug Evaluation and Research. “Today’s approval provides
patients with a treatment option.”
•Canakinumab is the only FDA-approved biologic for AOSD in the United States. In Europe, both
canakinumab and anakinra have regulatory approval. More targeted therapies are needed for AOSD.
FDA Approves First Treatment for Adult Onset Still’s Disease, a Severe and Rare Disease | FDA
References
Walt, L. VP Head of Medical Affairs, SOBI North America. https://www.youtube.com/watch?v=yqfTPgO-Z8k
Walt, L. VP Head of Medical Affairs, SOBI North America. https://www.youtube.com/watch?v=UFCoXSqFZNw
Innate immunity and adaptive immunity joint image
https://onlinelibrary.wiley.com/doi/epdf/10.1002/art.38615
Disease progression image
https://onlinelibrary.wiley.com/doi/full/10.1002/art.41107
Resent drug FDA approval
FDA Approves First Treatment for Adult Onset Still’s Disease, a Severe and Rare Disease | FDA
• Grumpy cat with still’s disease