Hospital for Sick Children, University of Toronto, Canada.
Am J Med Sci. 2012 May;343(5):367-70. doi: 10.1097/MAJ.0b013e3182514043.
No specific recommendations for the treatment of juvenile spondyloarthritis have been established. Important differences exist in how spondyloarthritis begins and progresses in children and adults, supporting the need for pediatric-specific recommendations. Recently published recommendations for the treatment of juvenile arthritis consider children with sacroiliitis in a separate group and allow for more accelerated institution of a tumor necrosis factor inhibitor depending on disease activity and prognostic factors that derive primarily from studies of other forms of juvenile arthritis. There is a need to develop measures of disease activity and prognosis specific for juvenile spondyloarthritis that reflect spinal disease, as well as other major clinical features, such as enthesitis, before significant progress can be made in this area.
目前尚未针对青少年脊柱关节炎的治疗制定具体建议。儿童和成人的脊柱关节炎发病和进展方式存在显著差异，这支持制定专门针对儿科的建议。最近发布的青少年关节炎治疗建议将伴有骶髂关节炎的儿童单独分组，并根据疾病活动度和主要来自其他类型青少年关节炎研究的预后因素，更积极地采用肿瘤坏死因子抑制剂治疗。在这一领域取得显著进展之前，需要开发专门针对青少年脊柱关节炎的疾病活动度和预后评估方法，这些方法应反映脊柱疾病以及附着点炎等其他主要临床特征。
