Medscape reports on new recommendations for the diagnosis and management of systemic juvenile idiopathic arthritis (sJIA) and adult-onset Still's disease (AOSD) that were presented at the European Alliance of Associations for Rheumatology (EULAR) 2023 annual meeting, suggesting the two conditions should be grouped into one disease, Stills disease.  

Karen Brandt Onel, MD, chief of Pediatric Rheumatology at HSS, and the principle investigator for 2021 American College of Rheumatology's (ACR) guidelines for sJIA noted the EULAR recommendations are congruent. One main difference is that the EULAR recommendations included timelines for treatment targets, while the ACR's did not, she continued. 

"It's great to have these timelines in there," cited Dr. Onel though there are still some unknowns. "We don't actually know what the tapering frequency should be," she said, "but these are definitely goals that we need to explore and see how they evolve."

The EULAR recommendations also touched on two concerning complications, particularly in children: macrophage activation syndrome (MAS) and lung disease. According to the document, MAS should be considered in patients with Still's disease with these symptoms: fever, splenomegaly, elevated serum ferritin, low cell counts, abnormal liver function tests, elevated serum triglycerides, and intravascular activation of coagulation.

The recommendations for lung disease are "broad," as there is still much to learn about the risk for lung disease in a small portion of sJIA patients, Dr. Onel said.

Read the full article at Medscape.com.