Turnier Jessica L, Brunner Hermine I
a Division of Rheumatology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center , University of Cincinnati College of Medicine , Cincinnati , OH , USA.
Expert Opin Biol Ther. 2016;16(4):559-66. doi: 10.1517/14712598.2016.1150997. Epub 2016 Feb 27.
Based on the known relevance of IL-6 in juvenile idiopathic arthritis (JIA) pathophysiology, tocilizumab has been investigated and approved for use in the treatment of systemic and polyarticular JIA. Tocilizumab is a humanized monoclonal antibody that inhibits signaling through both membrane bound and soluble IL-6R.
The purpose of this article is to summarize the available clinical data on the efficacy and safety of tocilizumab in JIA and to provide our opinion on the place of tocilizumab in current treatment regimens. A literature search for all relevant clinical trials and studies with regards to tocilizumab, JIA and IL-6 was performed through PubMed, in addition to a review of recent conference abstracts.
Tocilizumab has an important and evolving role in controlling disease activity in patients with JIA. It has proven useful even in patients whose JIA has previously been refractory to other biologic disease modifying anti-rheumatic drugs (DMARDs) and also appears quite effective as monotherapy. Tocilizumab is relatively well tolerated amongst JIA patients, with systemic JIA patients experiencing more serious adverse events overall.
基于白细胞介素-6（IL-6）在幼年特发性关节炎（JIA）病理生理学中的已知相关性，托珠单抗已被研究并获批用于治疗全身型和多关节型JIA。托珠单抗是一种人源化单克隆抗体，可抑制通过膜结合型和可溶性IL-6受体的信号传导。
本文的目的是总结托珠单抗治疗JIA的有效性和安全性方面的现有临床数据，并就托珠单抗在当前治疗方案中的地位提供我们的观点。除了回顾近期会议摘要外，还通过PubMed对所有关于托珠单抗、JIA和IL-6的相关临床试验和研究进行了文献检索。
托珠单抗在控制JIA患者的疾病活动方面具有重要且不断发展的作用。即使在先前对其他生物改善病情抗风湿药物（DMARDs）难治的JIA患者中，它也已被证明是有用的，并且作为单一疗法似乎也相当有效。在JIA患者中，托珠单抗的耐受性相对较好，全身型JIA患者总体上经历的不良事件更为严重。
