全身型幼年特发性关节炎治疗要点及进展

Key points and advances in the treatment of systemic juvenile idiopathic arthritis

全身型幼年特发性关节炎(sJIA)临床表型不一,以发热为突出表现,伴或不伴有关节炎、皮疹等特点,临床缺乏基于证据的指南,全球在sJIA治疗方面存在很大差异。该文总结了sJIA的传统药物(非甾体抗炎药、糖皮质激素、改善病情抗风湿药)、新兴生物制剂的治疗要点,以及近年来国内外关于sJIA治疗的推荐,并对目前关心的药物减停及疾病长期管理问题进行探讨,旨在对sJIA达标治疗的理念有更深入的认识,从而规范治疗策略、改善临床预后。

Systemic juvenile idiopathic arthritis(sJIA),in which fever is the prominent manifestation and which is accompanied with or without arthritis and rash,has different clinical phenotype.Until now,there are great differences in treatment of sJIA,inclucling due to lack of clinical evidence-based guidelines in the whole world.This review summarized the treatment points of sJIA,induding both traditional drugs(non-steroidal anti-inflammatory drugs,glucocorticoids,ameliorative antirheumatic drugs)and emerging biologics,and analysed some recommendations on the treatment of sJIA at home and abroad in recent years.In addition,we discussed the problems of drug withdrawal and long-term management of sJIA,aiming to better understand the concept of treat-to-target(T2T)in order to standardize the treatment strategy and improve the clinical prognosis of sJIA.