针对目标治疗的非全身性青少年性异常性关节炎儿童的疼痛显著减少:超过24个月的随访结果
Katinka Spekking1, Janneke Anink2, Piroska de Boer3
1Department of Pediatrics, Division of Pediatric Rheumatology, Willem-Alexander Children's Hospital, Leiden, The Netherlands. k.spekking@lumc.nl.
Pediatric rheumatology online journal
|August 26, 2023
概括
治疗到目标的策略有效地减少了青少年异常性关节炎 (JIA) 患者的疼痛. 基线特征如较高的疼痛分数和关节计数预测持续疼痛,有助于慢性疼痛发展的早期干预.
科学领域:
- 儿科 儿科 儿科
- 类风湿病学 类风湿病学
- 临床试验 临床试验
背景情况:
- 青少年无形性关节炎 (JIA) 在疼痛管理方面带来了挑战.
- 确定有效的治疗策略和持续疼痛的预测因素对于改善患者的治疗结果至关重要.
研究的目的:
- 为了比较JIA患者在三个向治疗策略中的疼痛评分.
- 确定基线特征,预测JIA中的持续疼痛.
主要方法:
- "最适合儿童"研究将92名 DMARD-naïve JIA 患者随机分为三个治疗手臂.
- 疼痛评分 (VAS) 在24个月内使用线性混合模型进行了分析.
- 一个多变量模型评估了随访期间高疼痛得分的基线预测因素.
主要成果:
- 平均疼痛分数在24个月内从55.3毫米显著降低到19.5毫米.
- 在这三种治疗策略之间没有观察到疼痛减轻的显著差异.
- 较高的基线VAS疼痛和活跃关节数量预测了随着时间的推移更高的疼痛;较低的医生VAS,CHQ物理和心理社会分数预测了更低的疼痛.
结论:
- 治疗到目标的方法在非系统性JIA的疼痛减轻方面是有效的,无论最初的策略如何.
- 确定基线预测因素可以帮助识别患有慢性疼痛的高风险的JIA患者.
相关概念视频
Inflammatory Bowel Disease IV: Pharmacological Management
152
Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
Pharmacologic...
152
Analgesia and Pain Management
654
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
654
Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF
173
Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab...
173
Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
195
Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
195
Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids
149
Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
149
Rheumatic Heart Disease III: Medical Management
12
Rheumatic heart disease (RHD) management can be divided into two main strategies: prevention and long-term management.Primary PreventionPrimary prevention focuses on timely diagnosis and management of group A streptococcal pharyngitis to prevent acute rheumatic fever. The most widely used antibiotic for treating this condition is intramuscular benzathine penicillin G.Acute Rheumatic Fever TreatmentThe primary treatment goal for a patient diagnosed with acute rheumatic fever is to suppress the...
12


