Clinica Pediatrica e Reumatologia, Paediatric Rheumatology International Trials Organisation (PRINTO), Istituto Giannina Gaslini, Genoa, Italy.
Direzione Scientifica, Istituto Giannina Gaslini, Genoa, Italy.
Lancet Child Adolesc Health. 2018 May;2(5):360-370. doi: 10.1016/S2352-4642(18)30034-8. Epub 2018 Feb 14.
The treatment of juvenile idiopathic arthritis has improved tremendously in the past 20 years as a result of appropriate legislative initiatives, large international collaborative networks, and the availability of new potent medications. Despite these considerable advances, a sizable proportion of patients are still resistant to treatment. Further improvement will stem from a better definition of the disease entities under the broad term juvenile idiopathic arthritis (which includes all forms of arthritis with disease onset before the age of 16 years); the discovery of laboratory and imaging biomarkers that could help the tuning of therapy; smoother implementation of clinical trials; more standardised links between academia, regulatory authorities, and patient organisations for the planning of future trials; and the availability of new drugs that selectively target molecules or pathways involved in inflammation.
过去 20 年来，由于适当的立法举措、大型国际合作网络以及新型强效药物的出现，幼年特发性关节炎的治疗得到了极大的改善。尽管取得了这些重大进展，但仍有相当一部分患者对治疗产生耐药性。进一步的改善将源于对幼年特发性关节炎（包括所有发病年龄在 16 岁以下的关节炎形式）这一广义术语下的疾病实体进行更明确的定义；发现有助于调整治疗的实验室和成像生物标志物；临床试验的实施更加顺畅；在学术、监管机构和患者组织之间建立更标准化的联系，为未来的试验规划；以及新型药物的出现，这些药物可以选择性地靶向炎症涉及的分子或途径。
