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Arthritis Rheumatol:使用一线重组白介素-1受体拮抗剂治疗新发全身型幼年特发性关节炎

2019-03-12 xiangting MedSci原创

使用rIL-1RA一线、短程单药治疗作为开始的靶向治疗是一种非常有效的策略。

全身型幼年特发性关节炎(JIA)是一种多因素的自身炎症性疾病,历来预后不良。使用目前的治疗方案,约一半的患者在治疗1年后仍然出现疾病活动。这个靶向治疗方法使用重组白介素-1受体拮抗剂(rIL-1RA,阿那白滞素)作为一线单药治疗,旨在达到早期非活动性疾病并防止损伤。

在这项单中心、前瞻性研究中,对NSAIDs反应不良的新发全身型JIA患者根据靶向治疗策略,接受rIL-1RA单药治疗。对2mg/kg rIL-1RA反应不完全的患者随后接受4mg/kg rIL-1RA、额外的泼尼松龙或换用替代疗法。达到非活动性疾病(ID)的患者,rIL-1RA在3个月后逐渐减量并随后停药。

42名患者的中位随访时间为5.8年,其中12名患者在发病时没有关节炎。达到ID的中位时间为33天。1年时,76%的患者达到ID,52%的患者为停药ID。基线时中性粒细胞计数高和rIL-1RA治疗1个月后完全反应与1年时的ID高度相关。随访5年后,95%的患者达到ID,72%为停药ID。<5%和仅33%的糖皮质激素治疗患者报告有关节或关节外损伤。rIL-1RA对发病时无关节炎的全身型JIA患者同样有效。

使用rIL-1RA一线、短程单药治疗作为开始的靶向治疗是一种非常有效的策略,可用于非活动性疾病的诱导和维持并预防全身型JIA的疾病和糖皮质激素相关损伤。

原始出处:

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    2019-03-14 lmm397
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    2019-03-14 zhaojie88
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