中国实用儿科杂志

中国实用儿科杂志 ›› 2026, Vol. 41 ›› Issue (8): 667-671.DOI: 10.19538/j.ek2026080611

• 专题笔谈 • 上一篇    下一篇

白细胞介素-6抑制剂在儿童风湿免疫性疾病中的应用

  

  1. 南京医科大学附属儿童医院风湿免疫科，江苏  南京  210000
  • 出版日期:2026-08-06 发布日期:2026-09-17
  • 通讯作者: 俞海国，电子信箱：haiguo_yu@njmu.edu.cn
  • 基金资助:
    国家自然科学基金项目（82271838）

Application status of IL-6 inhibitors in pediatric rheumatic and autoimmune diseases

  1. Department of Rheumatology and Immunology，Children’s Hospital of Nanjing Medical University，Nanjing  210000，China
  • Online:2026-08-06 Published:2026-09-17

摘要： 白细胞介素（IL）-6 抑制剂为儿童风湿免疫性疾病提供了靶向治疗选择。目前临床应用的IL-6 抑制剂包括靶向IL-6 受体的托珠单抗、沙利鲁单抗、萨特利珠单抗，靶向IL-6 的司妥昔单抗、奥洛珠单抗，以及选择性反式信号抑制剂奥拉奇西普；在儿童风湿免疫病领域，托珠单抗是国内惟一获批全身型幼年特发性关节炎适应证且常规可及的IL-6 抑制剂；在多关节型幼年特发性关节炎、大动脉炎、硬皮病、幼年特发性关节炎相关葡萄膜炎及皮肌炎等疾病中的超说明书用药已积累初步证据，临床应用前需常规筛查结核感染，治疗期间定期监测血常规、肝肾功能、血脂及炎症指标。未来需开展高质量儿童随机对照试验，明确拓展适应证、减停策略及长期安全性。

关键词: 白细胞介素-6 抑制剂, 托珠单抗, 儿童风湿免疫性疾病, 超说明书用药

Abstract: IL-6 inhibitors offer targeted therapeutic options for pediatric rheumatic and autoimmune disorders.Currently available IL-6 inhibitors include tocilizumab，sarilumab，and satralizumab targeting IL-6 receptor，siltuximab and olokizumab targeting IL-6，and selective trans-signaling inhibitor olamkicept.In the field of pediatric rheumatic and autoimmune diseases，tocilizumab is the only IL-6 inhibitor approved in China for the treatment of systemic juvenile idiopathic arthritis and is commercially available. Preliminary evidence supports its off-label use in conditions such as polyarticular juvenile idiopathic arthritis，Takayasu arteritis，scleroderma，juvenile idiopathic arthritis-associated uveitis，and dermatomyositis.Routine screening for tuberculosis is required prior to initiation of IL-6 inhibitor therapy，with regular monitoring of complete blood count，hepatic and renal function，lipid levels，and inflammatory markers during treatment.In the future，high quality randomized controlled trials are needed to clarify expanded indications，tapering and discontinuation strategies，and long-term safety.

Key words:  , IL-6 inhibitor, tocilizumab, pediatric rheumatic and autoimmune diseases, off-label use