[Successful treatment of adult Still's disease with tofacitinib in a HIV-2 positive female patient]

Z Rheumatol. 2020 Dec;79(10):1046-1049. doi: 10.1007/s00393-020-00853-9.
[Article in German]

Abstract

A 46-year-old female patient with a known HIV-2-infection suffered from adult onset Still's disease, which was initially complicated by a macrophage activation syndrome (MAS). The required glucocorticoid treatment induced a psychosis and the patient developed an aversion to glucocorticoids. After failure of treatment with anakinra, an alternative option with the JAK-inhibitor tofacitinib was introduced because of the short half-life and to reduce glucocorticoid exposure. A switch to tofacitinib was only successful after an overlapping treatment with anakinra and tofacitinib for 3 weeks. The patient is currently being treated with monotherapy with tofacitinib as well as NSAID on demand, is in stable remission and can continue working as normal.

Keywords: Adult-onset Still’s disease (AODS); Combination of JAK inhibitor and bDMARD; HIV; Rheumatoid arthritis; Tofacitinib.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Female
  • HIV Infections / complications*
  • HIV-2
  • Humans
  • Middle Aged
  • Piperidines / therapeutic use*
  • Protein Kinase Inhibitors / therapeutic use*
  • Pyrimidines / therapeutic use*
  • Pyrroles / therapeutic use*
  • Still's Disease, Adult-Onset* / complications
  • Still's Disease, Adult-Onset* / drug therapy
  • Treatment Outcome

Substances

  • Piperidines
  • Protein Kinase Inhibitors
  • Pyrimidines
  • Pyrroles
  • tofacitinib