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成人幼年特发性关节炎修订诊断:单中心回顾性研究。

Revising diagnosis of juvenile idiopathic arthritis in adults: a single-center retrospective study.

机构信息

Biologic Therapy Center, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland.

Clinic and Polyclinic of Systemic Connective Tissue Diseases, National Institute of Geriatrics, Rheumatology and Rehabilitation, Spartańska 1, 02-637, Warsaw, Poland.

出版信息

Rheumatol Int. 2023 Jul;43(7):1307-1311. doi: 10.1007/s00296-023-05293-7. Epub 2023 Mar 1.

Abstract

The study aimed to assess how many adult patients with juvenile idiopathic arthritis (JIA) treated with biologics fulfill classification criteria for adult rheumatic diseases and to evaluate the course of JIA in adulthood. 138 patients with JIA over 18 years old treated with biologics were included in a cross-sectional observative study. Among 138 adult patients with JIA treated with biologics, 81 patients remained with JIA diagnosis. 57 patients were rediagnosed. 31 patients met the criteria for spondyloarthropathy, among them 18 patients for ankylosing spondylitis, 10 patients for psoriatic arthritis, and 3 patients for non-radiographic axial spondyloarthritis. Rheumatoid arthritis was diagnosed in 24 patients and adults' Still disease in 2 patients. 84 patients of all adults with JIA received one biologic agent, 40 received two biologic agents, and 14 received three or more biologic therapies. 10 patients received biologic agents out of recommendations for JIA. Of the adult JIA patients treated with biologics, 41% met the classification criteria for adult inflammatory diseases. Spondyloarthropathy and rheumatoid arthritis were most commonly diagnosed. Nearly 40% of adult JIA patients required at least one modification of biological treatment. Therefore, it is worth considering a revision of JIA to adult-onset inflammatory disease entities, as it broadens the spectrum of disease-modifying drugs.

摘要

本研究旨在评估有多少接受生物制剂治疗的青少年特发性关节炎(JIA)成年患者符合成人风湿性疾病的分类标准,并评估 JIA 在成年期的病程。在一项横断面观察性研究中,纳入了 138 名接受生物制剂治疗的 18 岁以上 JIA 成年患者。在 138 名接受生物制剂治疗的 JIA 成年患者中,81 名仍保留 JIA 诊断,57 名重新诊断,31 名符合脊柱关节病标准,其中 18 名符合强直性脊柱炎,10 名符合银屑病关节炎,3 名符合非放射性中轴型脊柱关节炎。24 名患者被诊断为类风湿关节炎,2 名患者为成人Still 病。所有 JIA 成年患者中,84 名接受了一种生物制剂,40 名接受了两种生物制剂,14 名接受了三种或更多种生物治疗。10 名患者接受了生物制剂,而不是 JIA 的推荐治疗。在接受生物制剂治疗的 JIA 成年患者中,41%符合成人炎症性疾病的分类标准。最常见的诊断是脊柱关节病和类风湿关节炎。近 40%的 JIA 成年患者需要至少一种生物治疗的调整。因此,值得考虑将 JIA 修订为成人发病的炎症性疾病实体,因为这拓宽了疾病修饰药物的范围。

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