Department of Paediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong.
Department of Paediatrics and Adolescent Medicine, Tuen Mun Hospital, Tuen Mun, Hong Kong.
Hong Kong Med J. 2020 Feb;26(1):56-65. doi: 10.12809/hkmj198195.
Juvenile idiopathic arthritis (JIA) is the most common type of inflammatory arthritis in children. Treatment options have been expanded since the introduction of biologics, which are highly effective. The existing local JIA treatment guideline was published more than a decade ago, when use of biologics was not as common. In this article, we review the latest evidence on using biologics in three JIA subtypes: JIA of polyarticular course (pcJIA), enthesitis-related arthritis (ERA), and psoriatic arthritis (PsA). Based on the latest information, an update on eligibility, response assessment, termination, and safety information for using biologics in these patients was performed.
The JIA Work Group, which consisted of nine paediatricians experienced in managing JIA, was convened in 2016. Publications before July 2017 were screened. Eligible articles were clinical trials, extension studies, systemic reviews, and recommendations from international societies and regulatory agencies about the use of biologics in pcJIA, ERA, and PsA. Evidence extraction, appraisal, and drafting of propositions were performed by two reviewers. Extracted evidence and drafted propositions were presented and discussed at the first two meetings. Overwhelming consensus was obtained at the final meeting in May 2018. Seven practice consensus statements were formulated. Regular review should be performed to keep the practice evidence-based and up-to-date.
幼年特发性关节炎（JIA）是儿童中最常见的炎症性关节炎类型。自从生物制剂问世以来，治疗选择已经扩大，生物制剂非常有效。现有的局部 JIA 治疗指南是在十多年前发布的，当时生物制剂的使用并不常见。在本文中，我们回顾了三种 JIA 亚型（多关节病程 JIA [pcJIA]、附着点相关关节炎 [ERA] 和银屑病关节炎 [PsA]）中使用生物制剂的最新证据。根据最新信息，对这些患者使用生物制剂的资格、反应评估、终止和安全性信息进行了更新。
2016 年召集了由九名在管理 JIA 方面经验丰富的儿科医生组成的 JIA 工作组。筛选了 2017 年 7 月之前发表的出版物。合格的文章为临床试验、扩展研究、系统评价以及关于 pcJIA、ERA 和 PsA 中生物制剂使用的国际协会和监管机构的建议。由两名评审员进行证据提取、评估和提案起草。在头两次会议上展示和讨论了提取的证据和起草的提案。在 2018 年 5 月的最后一次会议上达成了压倒性共识。制定了七个实践共识声明。应定期审查，以保持实践的循证和最新。
