New therapeutic strategies are required in the management of adult-onset Still’s disease (AOSD) refractory to glucocorticoids, disease-modifying antirheumatic drugs (DMARDs) or anti-tumour necrosis factor α antagonists (anti-TNFs). It has been suggested that interleukin 1 (IL1) plays a key role in the maintenance of the chronic inflammatory diseases, providing a rationale for an IL1-blocking therapy.1 2 Anakinra, an IL1 receptor antagonist (IL1-RA) approved for the treatment of rheumatoid arthritis,3 has shown promising results in small cohorts of patients with AOSD.4 5 6 7 8 However, it is unclear whether these effects can be sustained over a long treatment period. We report rapid and long-lasting responses to anakinra in eight patients with AOSD refractory to glucocorticoids, DMARDs and/or anti-TNFs.

From December 2004, eight consecutive patients with refractory adult-onset …