Centre for Health Economics, University of Manchester, Oxford Road, Manchester, UK,
Curr Rheumatol Rep. 2015 May;17(5):31. doi: 10.1007/s11926-015-0508-1.
Juvenile idiopathic arthritis (JIA) is a poorly understood, heterogeneous, incurable, inflammatory syndrome. Long-term outcomes are uncertain, and this painful condition can result in lifelong disability. JIA is associated with considerable financial and humanistic burden for those affected and the healthcare system. Early diagnosis and effective treatment are indicated to optimise outcomes. Modern treatment aims to achieve remission and preserve joint function by using disease-modifying antirheumatic drugs (DMARDs) early. DMARDs can be classified as conventional/traditional or biologic. Biologic medications may be more effective but cost approximately ten times more than traditional DMARDs. Decision-makers in healthcare are increasingly comparing the cost and consequences of alternative treatment strategies to guide resource allocation decisions. There have been few economic evaluations to date to guide medicines optimisation in JIA. This systematic review highlights the lack of existing evidence relating to the humanistic and economic burden of JIA in the era of biologic medication.
幼年特发性关节炎（JIA）是一种病因不明、异质性强、无法治愈的炎症性综合征。长期预后不确定，这种痛苦的疾病可能导致终身残疾。JIA 给患者及其医疗体系带来了巨大的经济和人文负担。早期诊断和有效治疗可以优化预后。现代治疗的目标是通过早期使用疾病修饰抗风湿药物（DMARDs）来达到缓解和维持关节功能。DMARDs 可分为传统/常规药物和生物制剂。生物制剂可能更有效，但成本约为传统 DMARDs 的十倍。医疗保健决策者越来越多地比较替代治疗策略的成本和后果，以指导资源分配决策。迄今为止，针对 JIA 的药物优化，仅有少数经济评估来指导。本系统评价强调了在生物药物时代，缺乏与 JIA 的人文和经济负担相关的现有证据。
