Asklepios Clinic Sankt Augustin, Department of Pediatrics, Arnold-Janssen Str. 29, 53757 Sankt Augustin, Germany.
Expert Opin Biol Ther. 2013 Mar;13(3):361-76. doi: 10.1517/14712598.2013.735657. Epub 2013 Jan 5.
The development of biologics has markedly changed the treatment of JIA. Complete control of the disease and remission has today become the main goal of treatment preventing long-term damage and disability.
This review gives an overview of the current treatment options using biologics in JIA. The biologic drugs are discussed on the basis of recent clinical trials.
While JIA is a group of heterogeneous diseases, differences in their biology turned out to influence treatment success with different biologics. TNF inhibitors emerged to be the most commonly used biologics for the treatment of JIA. First they were successful for the treatment of rheumatoid factor positive and negative polyarticular JIA. TNF inhibitors have also been studied in patients with enthesitis-related arthritis, psoriatic arthritis, and extended olioarthritis, and approval of at least etanercept is expected. Second-line biologics are abatacept and tocilizumab. For systemic onset JIA, tocilizumab, and the IL-1 inhibitors anakinra and canakinumab have been successfully studied. In the treatment of JIA, biologics have emerged as potent drugs to control the disease. New advancements will be crucial for further improvement of treatment options in JIA.
生物制剂的发展显著改变了 JIA 的治疗方式。如今，完全控制疾病和缓解已成为治疗的主要目标，以预防长期损伤和残疾。
本文综述了目前使用生物制剂治疗 JIA 的选择。根据最近的临床试验，讨论了生物药物。
虽然 JIA 是一组异质性疾病，但它们的生物学差异似乎影响了不同生物制剂的治疗效果。TNF 抑制剂已成为治疗 JIA 的最常用生物制剂。首先，它们成功地治疗了类风湿因子阳性和阴性多关节炎 JIA。TNF 抑制剂也已在附着点相关关节炎、银屑病关节炎和扩展寡关节炎患者中进行了研究，预计至少批准依那西普。二线生物制剂为阿巴西普和托珠单抗。对于全身型 JIA，托珠单抗和 IL-1 抑制剂阿那白滞素和卡那单抗已成功进行了研究。在 JIA 的治疗中，生物制剂已成为控制疾病的有效药物。新的进展对于进一步改善 JIA 的治疗选择至关重要。
