托珠单抗治疗幼年特发性关节炎研究进展

Research update of Tolicizumab in the treatment of juvenile idiopathic arthritis

托珠单抗是抗白细胞介素（IL）-6受体（IL-6R）的重组人源单克隆抗体，通过抑制 IL-6与跨膜或可溶性 IL-6R 的结合，阻断 IL-6介导的信号转导，从而有效改善类风湿关节炎（RA）的炎性反应和关节破坏。在美国和欧盟，静脉注射托珠单抗已经被批准用于2岁以上的活动性幼年特发性关节炎全身型（sJIA）和多关节炎型（pJIA），2个针对2~17岁活动性 sJIA 和 pJIA 的随机、双盲、安慰剂对照、多国多中心的Ⅲ期临床研究为其在临床应用提供了依据。sJIA 和 pJIA 患儿对托珠单抗有较好的耐受性，不良反应有感染、粒细胞减少、肝功能损伤等。

Tocilizumab is a recombinant humanized monoclonal antibody against interleukin（IL）- 6 receptor （IL - 6R）. It can prevent IL - 6 from binding to membrane - bound or soluble IL - 6R,thus blocking IL - 6 mediated signal transduction,and clinically alleviating inflammation and joint destruction in rheumatoid arthritis（RA）. Both in the American and European Union,intravenous Tocilizumab has been approved for the treatment of both systemic juve-nile idiopathic arthritis（sJIA）and polyarticular JIA（pJIA）in patients aged ﹥ 2 years old. The approval was based on the favorable results from 2 randomized,double - blind,placebo - controlled,multinational,phase Ⅲ trials conducted in patients aged 2 - 17 years old with active sJIA or pJIA. Tocilizumab was generally well tolerated in patients with sJIA and pJIA. The most frequently reported adverse events in Tocilizumab recipients were infections,neutropenia,impaired liver function,etc.