Infliximab in the treatment of adult Still's disease refractory to conventional therapy

In this study we evaluated the efficacy of Infliximab in the treatment of a dult Still's disease (ASD) refractory to conventional therapy Three patient s with chronic and active ASD unresponsive to corticosteroids and methotrex ate were given intravenous Infliximab infusions at a dosage of 3 mg/kg at w eeks 0, 2, 6 and then once even 8 weeks. Merhotrexate was maintained in all cases at a dosage of 15 mg/week, whereas the prednisone dose was modified according to disease activity. The follow-up lasted 50 weeks and disease ac tivity improved in all cases during Infliximab therapy. Two patients pre se nted arthralgias and sore throat at 20 and 28 weeks, that was rapidly contr olled by Infliximab reinfusion every 4 weeks. One patient relapsed at 18 weeks and d ropped our at 22 weeks due to an urticarioid rash after the beginning of th e fifth infusion. Infliximab may be effective in the treatment of relapse o f ASD refractory to conventional therapy and requiring continuous high dose corticosteroid medication. Further studies are needed to evaluate the long -term safety, efficacy cy and the optimal schedule of infusion.