依那西普治疗幼年型特发性关节炎的疗效

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Rheumatology (Oxford). 2011 Jan;50(1):214-21. Complete control of disease activity and remission induced by treatment with etanercept in juvenile idiopathic arthritis. Papsdorf V, Horneff G. Deutsches Kinderrheumazentrum, Department of Paediatrics, Asklepios Klinik Sankt Augustin, Arnold Janssen Str. 29, 53757 Sankt Augustin, Germany. Abstract OBJECTIVES: To identify contributing factors associated with inactive disease (ID) and clinical remission for patients with juvenile idiopathic arthritis (JIA) treated with etanercept. METHODS: Data of an ongoing, long-term, multicentre, prospective, open-label observational study were analysed. Results. A total of 4898 follow-up forms from 787 JIA patients treated with etanercept were evaluated. Sixty-four per cent of the patients were female, 75% concomitantly received MTX and 45.9% received corticosteroids. Until the last observation, 47.6% of patients reached the criteria for ID and 26.6% achieved the remission on medication criteria. For both, ID and remission on medication, a significant influence of shorter disease duration (P<0.01 and P<0.001), a weekly dosage of at least 0.8 mg/kg (P=0.02), lower active joint counts (P=0.001) and lower childhood HAQ score (P<0.001 and P=0.004) at baseline was found. The odds ratio (OR) for a girl's chance to reach ID was 0.73 (P=0.049) and for remission on medication was 0.68 (P=0.04) compared with boys. The concomitant administration of MTX raised the relative chance, especially in patients with seronegative polyarthritis (OR 2.0; P=0.03). CONCLUSION: Upon treatment with etanercept, many JIA patients reached ID and remission on medication, although they had suffered from long-standing, refractory disease. Earlier initiation of treatment, less severe disease, use of at least the recommended weekly dosage of etanercept, and concomitant treatment with MTX seemed to independently increase the chance for reaching remission. These data should be confirmed by controlled prospective studies.

依那西普治疗幼年型特发性关节炎的疗效 Papsdorf V, et al.Rheumatology (Oxford). 2011 Jan;50(1):214-21.   目的：明确使用依那西普的JIA患者达到疾病不活动（ID）和临床缓解的相关因素。   方法：分析来自一项正在进行的长期多中心前瞻性开放性观察性研究的数据。   结果：共有来自787例使用依那西普的JIA患者的4898份随访表格。64%为女性，75%联用MTX，45.9%使用糖皮质激素。截止至末次观察，47.6%达到ID标准，26.6%达到缓解标准，ID和缓解与病程短（P<0.01，P<0.001）、每周剂量至少为0.8 mg/kg（P=0.02）、基线期活动性关节数少（P=0.001）和HAQ积分低（P<0.001，P=0.004）显著相关。与男性患儿相比，女性患儿达到ID和缓解的比值比分别为0.73（P=0.049）和0.68（P=0.04）。联用MTX提高了相对几率，特别是在血清阴性多关节炎患者中（OR 2.0; P=0.03）。   结论：依那西普治疗后，很多JIA患者到达ID和缓解。早期开始治疗、疾病严重度较低、至少使用依那西普的每周推荐剂量、联用MTX能独立增加达到缓解的几率。这些数据需要在前瞻性对照研究中加以证实。