中国实用儿科杂志

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阿达木单抗治疗幼年特发性关节炎近期疗效和安全性9例观察

许瑛杰吴凤歧赖建铭康闽   

  1. 作者单位: 首都儿科研究所附属儿童医院风湿免疫科, 北京
  • 出版日期:2015-01-06 发布日期:2014-12-31
  • 通讯作者: 吴凤歧

Observation on short-term efficacy and safety of adalimumab in treatment of  juvenile idiopathic arthritis

XU Ying-jieWU Feng-qiLAI Jian-mingKANG Min.   

  1. Children’s Hospital Affiliated to the Capital Institute of Pediatrics,Beijing 10020,China
  • Online:2015-01-06 Published:2014-12-31

摘要:

目的 探讨阿达木单抗在幼年特发性关节炎(JIA)患儿中的有效性和安全性。方法 收集2012年3月至2013年3月首都儿科研究所附属儿童医院风湿免疫科收入的诊断明确(除外全身型) 9 例JIA患儿,均存在预后不良因素(包括年龄小、 反复发作、 多关节受累、 关节病变重), 且常规治疗无效。9 例均予皮下注射阿达木单抗治疗(每2周1次, 共8次), 同时口服甲氨蝶呤或(和)来氟米特, 辅以理疗和功能锻炼。以美国儿科学会儿科达标率(ACR Pedi 30、 50、 70)作为病情改善评估标准, 分别在治疗后 6个月内每月1 次评分, 并监测不良事件。结果 治疗后1个月、 2个月及6个月时: ACR Pedi 30达标率分别为89%(8/9)、 100%(9/9)、 78%(7/9); ACR Pedi 50达标率分别为78%(7/9)、 89%(8/9)、 67%(6/9); ACR Pedi 70达标率分别为11%(1/9)、 67%(6/9)、 33%(3/9)。且 9 例均无重大不良事件发生。结论 阿达木单抗治疗幼年特发性关节炎具有较好的近期疗效, 不良反应小。

关键词: 阿达木单抗, 幼年特发性关节炎, 疗效, 不良反应

Abstract:

Abstracts: Objective To evaluate the efficacy and safety of adalimumab resistance in children with severe juvenile idiopathic arthritis. Methods Nine patients, who were diagnosed with JIA and had poor prognostic factors (including small age,recurrence,multiple joint involvement,bone destruction)and ineffective conventional therapy,were subcutaneously injected with adalimumab (twice a week,a total of eight times),and at the same time, oral methotrexate or (and) leflunomide were given,supplemented by physical therapy and functional exercise.Clinical efficacy was evaluated based on the ACR pediatric 30,50,70 improvement evaluation criteria,respectively,at a month,two months, three months,four months,five months and six months after treatment,and adverse events were monitored. Results After 1 month,2 months and 6 months, ACR Pedi 30 compliance rates were 89%,100% and 78%,ACR Pedi 50 compliance rates were 78%,89% and 67%,ACR Pedi 70 compliance rates were 11%,67% and 33%,and there were no significant adverse events. Conclusion Adalimumab treatment for severe juvenile idiopathic arthritis has good curative effect.The clinical efficacy is more significant in early course of disease.There is small and low occurrence of adverse reactions.

Key words: adalimumab;juvenile idiopathic , arthritis;efficacy;adverse reaction

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