Division of Rheumatology, Department of Pediatrics, Children's Mercy Hospitals and Clinics, 2401 Gillham Road, Kansas City, MO 64108, USA.
Best Pract Res Clin Rheumatol. 2014 Apr;28(2):293-313. doi: 10.1016/j.berh.2014.03.005.
The treatment of juvenile idiopathic arthritis (JIA) has substantially evolved over the past two decades. Research has been conducted and is ongoing on how therapies can best be utilized either as monotherapy or in combination for enhanced efficacy. The introduction of biologic therapies that selectively target specific cytokines has changed the acceptable clinical course of childhood arthritis. In addition to the development and utilization of new therapeutic agents, the pediatric rheumatology community has made vital progress toward defining disease activity, developing validated outcome measures, and establishing collaborative networks to assess both clinical outcomes and the long-term side effects related to therapeutics for juvenile arthritis. In this chapter, we will discuss the therapeutic evolution in JIA over the past two decades. Although the largest strides have been made with biologic agents, and these newer drugs have more rigorous data to support their use, select commonly used non-biologic therapies are included, with the discussion focused on more recent updated literature.
过去二十年中，幼年特发性关节炎（JIA）的治疗方法有了实质性的发展。目前正在进行研究，探讨如何最好地将各种疗法作为单一疗法或联合疗法使用，以提高疗效。针对特定细胞因子的生物疗法的出现改变了儿童关节炎的可接受临床病程。除了开发和利用新的治疗药物外，儿科风湿病学界在定义疾病活动、开发经过验证的结局指标以及建立协作网络以评估儿童关节炎的临床结局和与治疗相关的长期副作用方面也取得了重要进展。在本章中，我们将讨论过去二十年中 JIA 的治疗演变。虽然生物制剂取得了最大的进展，并且这些新药有更严格的数据支持其使用，但也包括了一些常用的非生物治疗方法，讨论重点是最近更新的文献。
