Autoinflammatory & rare systemic diseases
Current evidence on switching between biologic therapies for Still’s disease: A systematic literature review
Authors' conclusion
In patients with SD who are not meeting treatment targets, switching between bDMARDs can be a useful strategy associated with clinical benefits.
Study context
- Population
- Publications since 2014 on biologic treatment of Still's disease (SD); case reports, studies with under 5 patients and non-English publications excluded48 publications
- Comparison
- Switching between biologic disease-modifying antirheumatic drugs (bDMARDs) in Still's disease
- Outcome
- Evidence on switching between bDMARDs in SD
Main finding
As reported in the abstract
- Publications: 7 guidelines, consensus statements or best practice recommendations; 41 clinical trials, observational studies, registry studies or case series
- IL-1 inhibitors usually the recommended first-line biologics
- Switching to another IL-1 inhibitor or an IL-6 inhibitor recommended for lack of tolerability, inadequate response or treatment failure
- TNFi and JAKi suggested for later lines of therapy
- Clinical publications reported benefits of switching between bDMARDs: clinically inactive disease or remission, steroid-sparing effects, reduced treatment burden
Original publication
Current evidence on switching between biologic therapies for Still’s disease: A systematic literature review. Semin Arthritis Rheum. Published 18 July 2025. doi:10.
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