Global survey finds wide variation in macrophage activation syndrome treatment

The METAPHOR project surveyed 287 physicians from 64 countries about real-world treatment strategies for macrophage activation syndrome (MAS), a hyperinflammatory complication of rheumatologic disease most often seen with Still's disease. The survey found glucocorticoids, especially intravenous methylprednisolone, were consistently used as first-line therapy, with anakinra, ciclosporin, and intravenous immunoglobulins as the most common add-on agents, though choices varied by underlying disease and region. The authors reported that global disparities in availability of drugs such as anakinra and emapalumab significantly influenced treatment choices and were linked to greater reliance on steroid monotherapy.

Most relevant for: Clinicians managing patients with Still's disease or other rheumatologic conditions complicated by macrophage activation syndrome.

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