【摘要】 目的研究托珠单抗治疗活动性全身型幼年特发性关节炎(JIA)的近期临床疗效和不良反应。方法 26例活动性全身型JIA患儿接受托珠单抗(0周,第2,4,6,8周),同时继续口服稳定剂量的改善病情的抗风湿药(DMARDs),以美国风湿病学会(ACR)儿科30、50作为病情改善评估标准。评估项目包括:关节肿胀、疼痛、活动受限数目、部位、程度,机体功能的评估,实验室炎性指标如C反应蛋白(CRP)、红细胞沉降率(ESR)等变化。结果 26例JIA患儿托珠单抗治疗2周时ACR儿科30、50分别为47%(7/15例)、20%(3/15例),8周时分别为80%(12/15例)、53%(8/15例);托珠单抗治疗2周后,CRP、ESR等炎性指标不同程度下降,治疗4周后比较差异有统计学意义(P<0.05)。治疗前后血清中白细胞介素(IL)-6水平比较差异无统计学意义(P>0.05)。结论托珠单抗治疗活动性全身型JIA近期效果明显,安全性、耐受性较好。更多还原

【Abstract】 Objective To investigate the efficacy and safety of tocilizumab in patients with active systemic juvenile idiopathic arthritis(JIA). Methods Twenty-six patients with active systemic JIA(So-JIA) were treated with tocilizumab every 2 weeks along with stable dose of DMARDs. Patients were assessed by the American College of Rheumatology(ACR)response criteria(30,50) on week 2 and 8, including swollen joint count, tender joint count, duration of morning stiffness and fever, body functions, lab inflammatory index like CRP, ESR changes. Results Among 26 cases, according to ACR response criteria, which represents 30% and 50% improvement from baseline, the cure rates with tocilizumab therapy were achieved in 47%(7/15 cases) and 20%(3/15 cases) of patients with So-JIA on week 2;80%(12/15 cases) and 53%(8/15 cases) on week 8. Inflammatory index like CRP, ESR with tocilizumab treat-ment decreased considerably on week 4 compared that before treatment(P<0.05). There was no significant difference in serum IL-6 level between before and after treatment(P>0.05). Conclusions Tocilizumab showed a rapid cure rate,safety and better tolerance in patients of active So-JIA.更多还原