Rituximab therapy for refractory systemic-onset juvenile idiopathic arthritis

Systemic-onset juvenile idiopathic arthritis (SOJIA), formerly called Still’s disease, is a subset of juvenile arthritis that describes patients with fever, rash, arthritis, serositis and visceromegaly. In up to 30% of cases the disease has a chronic course and management requires high doses of glucocorticoids, disease-modifying antirheumatic drugs (DMARD), tumour necrosis factor alpha (TNFα) inhibitors or anakinra.1–6 However, this therapeutic arsenal is unable to control the disease in all patients. Recently, rituximab, a chimeric anti-CD20 monoclonal antibody, has been successfully used in two patients with refractory adult-onset Still’s disease.7 As the similarity of clinical and laboratory features present in SOJIA and adult-onset Still’s disease implies that these conditions have similar …