系统性青少年异常性关节炎:大奥蒙德街医院的经验 (2005-2021)
C M Foley1, D McKenna1, K Gallagher1
1Department of Paediatric Rheumatology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom.
Frontiers in pediatrics
|October 2, 2023
概括
早期生物治疗系统性青少年异常性关节炎 (sJIA) 显著改善了缓解率. 这项研究提出了英国SJIA的新治疗途径,倡导早期使用生物修饰性抗风湿药物 (bDMARDs).
科学领域:
- 儿科风湿病学 儿科风湿病学
- 免疫学 免疫学 免疫学
- 临床治疗学 临床治疗学
背景情况:
- 系统性青少年异常性关节炎 (SJIA) 是一种复杂的炎症性疾病.
- 了解sJIA的病理生理学已经进步,支持早期的IL-1或IL-6阻塞.
- 随着治疗环境的变化,需要对治疗策略进行重新评估.
研究的目的:
- 审查16年以上sJIA患者的临床表现,干预措施,并发症和缓解率.
- 确定与sJIA早期生物治疗相关的治疗信号.
- 为SJIA提出一个新的英国治疗途径,利用早期的bDMARDs.
主要方法:
- 对76名被诊断患有sJIA的儿童进行了回顾性病例笔记审查 (2005年10月至2021年10月).
- 对临床表现,治疗干预 (包括bDMARDs),并发症和缓解率的分析.
- 早期接受bDMARDs的患者与未接受bDMARDs的患者的结局的比较.
主要成果:
- 88%的患者在最后一次审查时获得了临床不活跃疾病 (CID);32%的患者获得了无治疗的CID.
- 36%的患者出现了巨细胞激活综合征.
- 在诊断后3个月内接受bDMARDs的儿童在1年内有显著更高的CID率 (90%对53%,p=0.002).
结论:
- 在sJIA中早期使用bDMARD与改善的短期缓解率有关.
- 在英国提出了一种针对sJIA的新治疗途径,强调早期bDMARDs.
- 迫切需要重新评估目前的NHS对sJIA的调试途径.
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