关键词: font-family:", font-size:17px, background-color:#FFFFFF, ">B 细胞靶向生物制剂, 儿童系统性红斑狼疮, 幼年型皮肌炎, 抗中性粒细胞胞浆抗体相关性血管炎

Abstract: B-cell-targeted biologics have brought transformative advances to the treatment of pediatric rheumatic and immune diseases. Belimumab is currently the only biologic agent approved and covered by national health insurance for childhood systemic lupus erythematosus（SLE）in China. Rituximab has accumulated extensive clinical experience in refractory pediatric SLE，lupus nephritis，ANCA-associated vasculitis，and juvenile dermatomyositis. The use of telitacicept in pediatric patients represents off-label use. Obinutuzumab，a novel type Ⅱ anti-CD20 monoclonal antibody，has demonstrated significant efficacy in the trial in adult SLE，while the pediatric trial is currently underway. This article，integrating guideline recommendations and clinical research，discusses the indication positioning，dosing regimens，tapering and discontinuation strategies，and safety management of the aforementioned agents，aiming to provide a reference for rational clinical use.

Key words: B-cell-targeted biologics, childhood-onset systemic lupus erythematosus, juvenile dermatomyositis, ANCA-associated vasculitis