#2-11E. Seizing the Moment: Early IL-1 Inhibition Defines the Treatment Window in Still's Disease (ACRO, 2025)

Should we prioritize rapid initiation of targeted biologic therapy in systemic autoinflammatory diseases like Still’s disease? Delayed treatment risks chronic involvement and potentially fatal complications like Macrophage Activation Syndrome (MAS). This retrospective analysis studied 42 adult patients with Still’s disease treated with Interleukin-1 inhibitors (IL-1i) to evaluate whether early intervention (within six months of symptom onset) improved outcomes compared to late treatment. The core finding supports the concept of a "window of opportunity" in Still’s disease management, showing that early IL-1i introduction was associated with a trend toward higher rates of clinical inactive disease (CID) achievement and successful glucocorticoid discontinuation4.... Clinicians should note, however, that the results are subject to limitations inherent to the retrospective study design and small sample size (n=42), constraining definitive causal conclusions and generalizability. Nevertheless, this study reinforces the clinical imperative for prompt diagnosis and immediate therapeutic intervention to prevent disease progression and mitigate long-term corticosteroid reliance in your daily practice.

Citation: Bindoli S, Cadore C, Guidea I, Doria A, Ramonda R, Sfriso P. Early IL-1 Inhibition in Still’s Disease: A Window of Opportunity for Improving Outcomes. ACR Open Rheumatology. 2025. DOI: 10.1002/acr2.70106

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