Adult Onset Still's Disease: Rheumatologists share findings with the world
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| Dr. Satish Odhav, above left, and Dr. Jacob Aelion presented their clinical observations to thousands of their peers from around the world at the annual meting of the European League Against Rheumatism in Berlin. |
After corroborating the observation in two more patients with this condition, the Jackson physicians decided to share their experience with the wider rheumatology community. They submitted an abstract for review to the European League Against Rheumatism (EULAR), had it accepted, and found themselves presenting their data to thousands of their peers from across the world at EULAR’s annual meeting last June in Berlin, Germany.
“Being able to present was both gratifying and a little bit humbling,” says Dr. Aelion. “Gratifying because four Canadian universities presented an abstract with the same observation in seven patients with AOSD, and humbling because our abstract received as much attention, if not more, as other abstracts describing conclusions of multi-million dollar studies.”
“Our reprints were gone within the first two hours,” says Dr. Odhav. He remembers being busy trying to find a place to make more reprints, but there was not enough time.
The observation was first made in September 2001 when an elderly patient came to their clinic with prolonged fever, weight loss, and a progressive debilitating condition. She already had undergone several medical workups both in Jackson and Memphis, including exploratory laparotomy (surgery). No one seemed to know why this patient was wasting away.
The Jackson rheumatologists diagnosed her with AOSD and started treatment. Some AOSD patients respond to the use of simple anti-inflammatory medications while others need more aggressive therapy with cortisone therapy. This patient responded to neither. Dr. Odhav and Dr. Aelion decided to try Anakinra, at that time a new FDA-approved drug for rheumatoid arthritis. The response was dramatic, the physicians said. Within days the patient started improving.
“The patient had nothing else to lose, so the drug was certainly worth trying,” says Dr. Odhav.
In June 2003, they saw a 32-year-old mother of two with a similar condition. She had difficulty getting out of bed because of joint pain and profound weakness. She had been running a high daily temperature for several weeks. Again, Anakinra was tried. Within three days the fever resolved and the musculoskeletal complaints improved.
Shortly thereafter, a third patient with AOSD showed similar results with the drug. That is when Dr. Aelion and Dr. Odhav decided to write a paper on the use of Anakinra in AOSD.
The Arthritis Clinic is involved in 15 clinical trials with various new medications for rheumatoid arthritis, lupus, and osteoporosis. Dr. Aelion and Dr. Odhav encourage other Jackson physicians and surgeons to present any relevant clinical observations at national and international meetings.
“Presentation at conferences and clinical studies highlight the success of the medical community,” says Dr. Odhav. “The Jackson medical community deserves better recognition.”