Department of Pediatrics, Aarhus University Hospital Skejby,Aarhus N, Denmark.
Expert Rev Clin Immunol. 2012 Aug;8(6):517-25. doi: 10.1586/eci.12.49.
Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in childhood, resulting in short- and long-term disability. It includes a heterogeneous group of diseases, of which systemic JIA is often resistant to treatment. IL-6 plays a significant role in systemic JIA since it is elevated in serum and correlates with disease activity, including joint involvement, acute phase reactants and fever. Blocking the IL-6-induced signal could therefore be an attractive treatment approach. The use of tocilizumab, a humanized anti-IL-6 receptor antibody, for the treatment of systemic JIA is described. The purpose has been to review the controlled clinical trials evaluating the efficacy and safety of tocilizumab for the treatment of systemic JIA. In two Phase III randomized, double-blind controlled studies a rapid and high response rate has been achieved both regarding systemic features and arthritis activity together with a tolerable safety profile in children with systemic JIA refractory to conventional treatment.
幼年特发性关节炎（JIA）是儿童中最常见的风湿性疾病，导致短期和长期残疾。它包括一组异质性疾病，其中全身性 JIA 通常对治疗有抗性。IL-6 在全身性 JIA 中起重要作用，因为它在血清中升高并与疾病活动相关，包括关节受累、急性期反应物和发热。因此，阻断 IL-6 诱导的信号可能是一种有吸引力的治疗方法。使用托珠单抗，一种人源化抗 IL-6 受体抗体，治疗全身性 JIA 已被描述。目的是回顾评估托珠单抗治疗全身性 JIA 的疗效和安全性的对照临床试验。在两项 III 期随机、双盲对照研究中，在常规治疗无效的全身性 JIA 儿童中，均迅速达到了全身性特征和关节炎活动的高反应率，同时具有可耐受的安全性特征。
