University of Alabama at Birmingham, Pediatric Rheumatology, 1600 7th Ave S, CPPN G10, Birmingham, AL, 35233, USA.
University of Alabama at Birmingham, Pediatric Rheumatology, 1600 7th Ave S, CPPN G10, Birmingham, AL, 35233, USA.
Curr Opin Pharmacol. 2022 Jun;64:102226. doi: 10.1016/j.coph.2022.102226. Epub 2022 Apr 20.
Recent development of new medications has changed the juvenile idiopathic arthritis (JIA) treatment goal to inactive disease. With numerous options, how does a clinician choose which medication to use? Treatment options may depend on the clinical classification and a new paradigm considers the JIA subtypes in reference to categories of adult inflammatory arthritis; poligo JIA, spondyloarthritis JIA, and systemic JIA that can help guide a clinician in determining treatment options. Treatment strategies such as consensus treatment plans can provide guidance on treatment escalation. However, a treat-to-target strategy using frequent standardized disease activity measurements, shared decision making with the patient, and treatment escalation to achieve the disease activity target can provide a personalized approach to managing JIA.
新药物的研发改变了幼年特发性关节炎（JIA）的治疗目标，使其达到疾病无活动状态。有如此多的选择，临床医生如何选择使用哪种药物？治疗选择可能取决于临床分类，而一种新的范例将 JIA 亚型考虑为成人炎症性关节炎的类别；多关节型 JIA、脊柱关节型 JIA 和全身型 JIA，这有助于指导临床医生确定治疗选择。治疗策略，如共识治疗计划，可以为治疗升级提供指导。然而，采用目标治疗策略，即频繁使用标准化疾病活动测量、与患者共同决策以及进行治疗升级以实现疾病活动目标，可以为管理 JIA 提供个性化方法。
