Infliximab therapy and outcomes in patients with polyarticular juvenile idiopathic arthritis:a single-center study in China
作者机构：Ministry of Education Key Laboratory of Child Development and DisordersChildren's Hospital of Chongqing Medical UniversityChongqingChina Chongqing Key Laboratory of Child Infection and ImmunityChildren's Hospital of Chongqing Medical UniversityChongqingChina Division of Immunology and RheumatologyChildren's Hospital of Chongqing Medical UniversityChongqingChina
出 版 物：《World Journal of Pediatrics》 (世界儿科杂志（英文版）)
年 卷 期：2020年第16卷第1期
页 面：68-73页
核心收录：
学科分类：1004[医学-公共卫生与预防医学(可授医学、理学学位)] 1002[医学-临床医学] 100202[医学-儿科学] 10[医学]
基 金：This work was supported by the Chongqing Health and Family Planning Commission Fund(2016MSXM033).
主 题：Infliximab Outcomes Polyarticular juvenile idiopathic arthritis Treatment opportunity
摘 要：Background Juvenile idiopathic arthritis(JIA)is a chronic inflammatory disease that includes seven heterogeneous subgroups with different prognoses.In particular,polyarticular JIA(pJIA)has a longer period of active disease and a poorer prognosis.Tumor necrosis factor(TNF)-alpha inhibitors are effective in patients with pJIA,but the therapeutic regimen remains controversial.Here,we performed a single-center study to determine the potential correlation between TNF-alpha inhibitor(infliximab)therapy and outcomes in these patients.Methods Clinical data of 40 pJIA patients were collected at our center from January 1,2010 to January 1,2018,and patients were grouped according to the timing of infliximab therapy.The erythrocyte sedimentation rate(ESR),the number of joints with active disease,and the 27-point juvenile arthritis disease activity score(JADAS-27)were analyzed.Results The ESR,the active joint count,and the JADAS-27 decreased significantly in all groups after 3 months(P=0.041/0.415/0.008,0.022/0.030/0.001,and 0.05/0.012/0.001,respectively)and 6 months(P=0.036/0.045/0.041,0.076/0.037/0.001,and 0.096/0.006/0.001,respectively)of infliximab treatment,although the rates of change of these parameters were similar.However,after 12 months,only patients treated with infliximab within 3 months of disease onset had a stable ESR,active joint count,and JADAS-27,while these parameters increased sharply when infliximab was administered 3 months and especially 1 year after disease onset.Conclusions TNF-alpha is a pleiotropic pro-inflammatory cytokine of crucial importance in the pathogenesis of JIA.Infliximab can improve the outcomes of patients with pJIA significantly,and should be introduced early during the clinical course.
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