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Proinflammatory cytokines like tumour necrosis factor α (TNFα), interleukin (IL) 6, IL18, and IL1 have been implicated in the pathogenesis of several chronic rheumatic inflammatory diseases, including juvenile idiopathic arthritis and adult onset Still’s disease (AOSD).1–,5 The treatment of these diseases includes non-steroidal anti-inflammatory drugs (NSAIDs), systemic corticosteroids and, in resistant cases, methotrexate (MTX), cyclophosphamide, sulfasalazine, and ciclosporin A6–,8 have been used. Over the past years, several cases of successful treatment with infliximab and etanercept in AOSD, refractory to conventional drugs, have been published.8,9
We report a favourable response to anakinra in a patient unresponsive to several disease modifying antirheumatic drugs (DMARDs) and …