Low dose efficacy of etoposide on conventional treatment-refractory adult-onset Still disease / 中华风湿病学杂志

ABSTRACT

Objective To assess the efficacy of low-dose etoposide in patients with adult-onset Still disease (AOSD) refractory to conventional treatment.Methods This was a retrospective study of etoposid treatment in 24 patients with conventional treatment-refractory AOSD.Mann-Whitney U-test,Student's t test and chi-squared test were used for analysis.Results The age of the patients was (38±13) years.The median duration of AOSD before etoposide initiation was 2.5 months [interquartile range (IQR)] 1 month to 14 years).The median dosageof etoposide was 575 mg (IQR 150-1 400 mg).The median treatment course was 4 weeks (IQR 2 weeks to 10 months).Etoposide treatment resulted in rapid and maintained improvement in both clinical and laboratory parameters.The median dosage of methylprednisolone was also reduced.The most common side effectwas infection,and other side effects were mild leukopenia or neutropenia,gastrointestinal effects and hair loss.Two patients died and 22 patients survived.With an average follow-up of 14 months (IQR 1-32 months),4 of which were treated with corticosteroid alone,and 18 patients were treated with corticosteroid plus immunosuppressive agents.The patient's condition was stable without disease flare.Conclusion Etopo-side treatment is associated with rapid and maintained clinical and laboratory improvement in patients with refractory AOSD.Infection is the most common side effect.It is necessary to carry out large samples and longterm follow-up clinical studies to evaluate its exact effect and safety.