Nada Doaa W, Moghazy Abdelkawy, Allam Abdallah El-Sayed, Alunno Alessia, Ibrahim Amira M
Physical Medicine, Rheumatology and Rehabilitation Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
Rheumatology and Rehabilitation Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Front Med (Lausanne). 2021 May 10;8:665028. doi: 10.3389/fmed.2021.665028. eCollection 2021.
Systemic Juvenile Idiopathic Arthritis (sJIA) is a unique category of juvenile arthritis in which interleukin 6 plays a major pathogenic role. This study aimed to describe the therapeutic short-term outcomes among patients with sJIA starting tocilizumab (TCZ) therapy and to identify possible predictors of treatment response. We conducted a prospective observational study including 65 patients with sJIA meeting ILAR classification criteria with active disease despite conventional therapy that were treated by TCZ between August 2019 and October 2020 as the first-line biological therapy. Clinical and serological parameters were recorded at baseline and after 1 year of TCZ therapy. After 1 year, 25% of the patients achieved minimal disease activity and 35% achieved clinically inactive disease. A significant reduction of the 10-joint juvenile arthritis disease activity score and acute phase reactants was also observed. Patients with younger age (≤7 years), shorter disease duration (≤3 years), lower disease activity, and higher serum ferritin and systemic manifestations showed more favorable results. Patients with sJIA showed favorable disease outcomes with TCZ treatment for 1 year, especially if the drugs were administered earlier in the disease course and in younger patients with a more pronounced inflammatory status. Our results may help to define the profile of patients with sJIA who are more likely to benefit from IL-6 blockade.
全身型幼年特发性关节炎（sJIA）是幼年关节炎的一种独特类型，其中白细胞介素6起主要致病作用。本研究旨在描述开始使用托珠单抗（TCZ）治疗的sJIA患者的短期治疗结果，并确定治疗反应的可能预测因素。我们进行了一项前瞻性观察性研究，纳入了65例符合国际风湿病联盟（ILAR）分类标准、尽管接受了传统治疗但仍有活动性疾病的sJIA患者，这些患者在2019年8月至2020年10月期间接受TCZ作为一线生物治疗。在基线和TCZ治疗1年后记录临床和血清学参数。1年后，25%的患者达到最小疾病活动度，35%的患者达到临床无活动疾病状态。还观察到10关节幼年关节炎疾病活动评分和急性期反应物显著降低。年龄较小（≤7岁）、病程较短（≤3年）、疾病活动度较低、血清铁蛋白较高和有全身表现的患者显示出更有利的结果。sJIA患者接受TCZ治疗1年显示出良好的疾病结果，特别是如果在疾病病程早期给药，且在炎症状态更明显的年轻患者中给药。我们的结果可能有助于确定更有可能从IL-6阻断治疗中获益的sJIA患者的特征。
