关于多关节性青少年异常性关节炎治疗策略的现实生活数据
Emine Özçelik1, Elif Çelikel2, Zahide Ekici Tekin2
1Division of Pediatric Rheumatology, Department of Pediatrics, University of Health Sciences, Ankara Bilkent City Hospital, Bilkent, 06800, Ankara, Turkey. eminealtiokk@gmail.com.
European journal of pediatrics
|September 30, 2025
概括
多关节性青春性异常性关节炎 (pJIA) 可以单独使用甲状腺素来治疗,但有些患者需要生物修饰性抗风湿药物 (bDMARDs). 六个月高的疾病活性得分可以预测在pJIA中需要bDMARDs.
科学领域:
- 类风湿病学 类风湿病学
- 儿科风湿病学 儿科风湿病学
- 免疫学 免疫学 免疫学
背景情况:
- 多关节性青春性异常性关节炎 (pJIA) 呈现异质的治疗反应.
- 像青少年关节炎疾病活动评分 (JADAS-71) 这样的客观工具对于监测疾病活动和指导pJIA治疗至关重要.
- 虽然具有挑战性,但一些pJIA患者通过甲基酸盐 (MTX) 单一治疗实现了缓解.
研究的目的:
- 为了比较pJIA患者在MTX单疗中开始治疗的结果,与需要添加生物疾病修饰性抗风湿药物 (bDMARDs) 的患者进行比较.
- 确定在pJIA管理中需要bDMARDs的预测因素.
主要方法:
- 在2013年1月至2023年12月期间接受治疗的78名pJIA患者的回顾性分析.
- 患者被分为MTX单疗法 (n=23) 和MTX+bDMARDs (n=55) 组.
- 使用JADAS-71评估疾病活动,使用少年关节炎损害指数 (JADI) 评估损害.
主要成果:
- MTX + bDMARDs组的诊断时间更长,肘部参与更多,随访时间更长,疾病不活跃的时间更长.
- 两组之间在诊断时没有JADAS-71的显著差异.
- 在MTX + bDMARDs组中,3个月,6个月和12个月显著更高的JADAS-71和JADI值.
结论:
- 单独使用甲德治疗可以在一些pJIA患者中诱导缓解.
- 较高的JADAS-71和JADI-Articular分数表明可能需要bDMARDs.
- 6个月高的JADAS-71值可以预测bDMARDs在pJIA的开始.
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