On demand corticosteroid use in the syndrome of undifferentiated recurrent fever: a literature review and results from JIR-CLiPS survey study
Authors' conclusion
On-demand corticosteroid use is not uncommon in the acute management of SURF attacks. However, most physicians do not use corticosteroids routinely and there is no consensus regarding the definition of response to treatment and when to change treatment neither in our survey results nor in the literature.
Study context
- Population
- Physicians (66.4% paediatric rheumatologists) from 45 countries; published syndrome of undifferentiated recurrent fever (SURF) patients treated with on-demand corticosteroidsphysicians, 45 countries
- Participants
- 137 physicians
- Outcome
- Physicians' strategies regarding corticosteroid use in SURF
Methodological detailsquestionnaire survey (JIR-CliPS), systematic review of MEDLINE and Scopus
- Questionnaire survey (JIR-CliPS)
- Systematic review of MEDLINE and Scopus
Main finding
As reported in the abstract
Physicians' corticosteroid practices in SURF (survey)
- Prescribe corticosteroids for SURF flares
- Around 70%
- Do not use corticosteroids routinely in SURF patients
- 81.9%
- Not using corticosteroids routinely more common among less experienced physicians
- p<0.001
- Prednisolone 1 mg/kg most commonly preferred corticosteroid
- 54.4%
- Most common definition of response: 'response within 12 hours'
- 51.6%
- Consider changing treatment if corticosteroids decrease quality of life
- 59.5%
Observational data: associations, not effects.
Further findings
Literature review: SURF patients treated with on-demand corticosteroids (10 articles, 239 patients)
- Prednisolone most frequently preferred corticosteroid
- 63.8%
- Response to corticosteroids
- 70.8%
Safety
Increase in attack frequency with on-demand corticosteroids (literature)
- Increase in attack frequency
- almost 40%
Original publication
On demand corticosteroid use in the syndrome of undifferentiated recurrent fever: a literature review and results from JIR-CLiPS survey study. Clin Exp Rheumatol. Published 5 November 2024. doi:10.
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