Systemic juvenile idiopathic arthritis and adult-onset Still's disease are the same disease: evidence from systematic reviews and meta-analyses informing the 2023 EULAR/PReS recommendations for the diagnosis and management of Still's disease
Authors' conclusion
Our results argue for a continuum between sJIA and AOSD.
Study context
- Population
- Cohort studies comparing systemic juvenile idiopathic arthritis (sJIA) vs adult-onset Still's disease (AOSD) with at least 20 patients per group (SR1); biomarker studies in both diseases (SR2); diagnostic biomarkers for macrophage activation syndrome (MAS) (SR3)8 studies in SR1
- Participants
- 1,010 participants
- Comparison
- sJIA vs AOSD
- Outcome
- Similarity in clinical manifestations and laboratory findings between sJIA and AOSD
Methodological detailsthree systematic reviews, meta-analyses of proportions, risk of bias: adapted Hoy scale (SR1), QUADAS-2 (SR2, SR3), Medline (PubMed), Embase and Cochrane Library systematically searched
- Three systematic reviews
- Meta-analyses of proportions
- Risk of bias: adapted Hoy scale (SR1), QUADAS-2 (SR2, SR3)
- Medline (PubMed), Embase and Cochrane Library systematically searched
Pooled result
As reported in the abstract
Pooled prevalence of clinical manifestations, complications and biological findings
- Pooled prevalence of clinical manifestations did not differ between sJIA and AOSD, except myalgia, sore throat and weight loss, more frequent in AOSD than sJIA
- Except for AA amyloidosis, more frequent in sJIA than AOSD, prevalence of complications did not differ
- Prevalence of biological findings did not differ
Further pooled results
Diagnostic biomarkers (SR2, 33 studies)
- Ferritin, S100 proteins and IL-18 were the most frequently used diagnostic biomarkers, with similar diagnostic performance
Biomarkers for MAS diagnosis (SR3, 10 studies)
- Novel biomarkers such as IL-18, C-X-C motif ligand 9, adenosine deaminase 2 activity and activated T cells seemed promising
Original publication
Systemic juvenile idiopathic arthritis and adult-onset Still's disease are the same disease: evidence from systematic reviews and meta-analyses informing the 2023 EULAR/PReS recommendations for the diagnosis and management of Still's disease. Ann Rheum Dis. Published 14 November 2024. doi:10.
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