Medicina clinica · 2026
Utility of systemic score as a prognosis marker and biologic treatment indication in adults with Still's disease.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Casafont-Solé Ivette, Mora Maribel, Narváez Javier, Nolla Joan Miquel, Olivé Alejandro, Holgado Susana
Аннотация
OBJECTIVES: To evaluate the prognostic utility of the Systemic Score (SS) in a Spanish cohort of patients with adult-onset Still's disease (AOSD), with a focus on its ability to predict disease complications, need for biologic therapy and mortality.
METHODS: A retrospective study was conducted in two university hospitals. Clinical, laboratory, complication-related data, biologic treatments, and deaths (AOSD-related or not) were recorded. The SS was calculated at disease onset, assigning one point to each of 12 variables. A score ≥7 is considered high risk. The association between SS and clinical course, complications, biologic treatment, and AOSD-related death was analyzed.
RESULTS: Data from 64 patients were analyzed. SS was <7 in 78.13% and ≥7 in 21.87%. A score ≥7 was significantly associated with macrophage activation syndrome, pericarditis, pleuritis, and renal involvement. Although myocarditis, and amyloidosis were not significantly associated, most individual cases showed SS≥7. Biologic treatment was more frequently required in patients with SS≥7. No association was found with clinical patterns or non-AOSD-related deaths. Both AOSD-related deaths had SS≥7, though the small number of cases limits interpretation.
CONCLUSIONS: SS is a valuable prognostic tool in patients with AOSD, allowing early identification of individuals at higher risk of severe complications and treatment escalation. It may help identify patients at high risk for complications and in need of biologic therapy.
METHODS: A retrospective study was conducted in two university hospitals. Clinical, laboratory, complication-related data, biologic treatments, and deaths (AOSD-related or not) were recorded. The SS was calculated at disease onset, assigning one point to each of 12 variables. A score ≥7 is considered high risk. The association between SS and clinical course, complications, biologic treatment, and AOSD-related death was analyzed.
RESULTS: Data from 64 patients were analyzed. SS was <7 in 78.13% and ≥7 in 21.87%. A score ≥7 was significantly associated with macrophage activation syndrome, pericarditis, pleuritis, and renal involvement. Although myocarditis, and amyloidosis were not significantly associated, most individual cases showed SS≥7. Biologic treatment was more frequently required in patients with SS≥7. No association was found with clinical patterns or non-AOSD-related deaths. Both AOSD-related deaths had SS≥7, though the small number of cases limits interpretation.
CONCLUSIONS: SS is a valuable prognostic tool in patients with AOSD, allowing early identification of individuals at higher risk of severe complications and treatment escalation. It may help identify patients at high risk for complications and in need of biologic therapy.