J Rheumatol:托珠单抗治疗多关节型幼年特发性关节炎期间的生长情况:III期临床试验数据

2018-07-09 xiangting MedSci原创

基线Tanner分期≤3的pcJIA患者中,72%(74/103)在研究结束时身高SDS升高。

这项研究旨在评估III期试验中使用托珠单抗(TCZ)治疗多关节型幼年特发性关节炎(pcJIA)长达2年患者的生长情况。

病情持续至少6个月且对甲氨蝶呤反应不良的pcJIA患者每4周静脉注射1次开放标签的TCZ,共16周(如果体重<30kg,则随机分为8或10mg/kg;如果体重≥30kg,则接受8mg/kg)。第16周有JIA美国风湿病学会30应答的患者被随机分为TCZ组或安慰剂组,治疗24周,并开放标签延长至104周。在接受1剂以上TCZ并未接受生长激素治疗的患者和基线Tanner分期≤3的患者中测量身高速度平均值±SD(厘米/年)和世界卫生组织(WHO)身高SD评分(SDS)。

该研究纳入188例患者中的187例(99.5%)。其平均WHO身高SDS 为-0.5±1.2,这与年龄或病程无关(Spearman等级相关性分别为(r=0.08和r=-0.12)。基线时123例患者的Tanner分期≤3,其中103例患者完成了2年身高SDS数据的研究。平均身高SDS从基线到第2年升高(+0.40,p<0.0001)。103例患者中的74例(72%),身高SDS大于基线,平均身高速度为6.7±2.0cm/年。

基线Tanner分期≤3的pcJIA患者中,72%(74/103)在研究结束时身高SDS升高。

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createdName=xinxin088, createdTime=Fri Jun 14 22:51:00 CST 2019, time=2019-06-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2055255, encodeId=19632055255e3, content=<a href='/topic/show?id=6f9391e7414' target=_blank style='color:#2F92EE;'>#试验数据#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=91774, encryptionId=6f9391e7414, topicName=试验数据)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdqq.qlogo.cn/qqapp/1103841572/656F31B644588474D1C46903A7F84373/100, createdBy=4e842500199, createdName=ms24272190615788285182, createdTime=Tue Aug 28 01:51:00 CST 2018, time=2018-08-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1916022, encodeId=93e4191602215, content=<a href='/topic/show?id=c5a89550ff' target=_blank style='color:#2F92EE;'>#III#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9550, encryptionId=c5a89550ff, topicName=III)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e68e415, createdName=juliusluan78, createdTime=Tue Oct 16 17:51:00 CST 2018, time=2018-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1931438, encodeId=4b9a193143821, content=<a href='/topic/show?id=a3d89601f2' target=_blank style='color:#2F92EE;'>#II期临床试验#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9601, encryptionId=a3d89601f2, topicName=II期临床试验)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Sat Apr 20 05:51:00 CST 2019, time=2019-04-20, status=1, ipAttribution=), 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createdName=lmm397, createdTime=Wed Jul 11 06:51:00 CST 2018, time=2018-07-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1524651, encodeId=7f1c152465174, content=<a href='/topic/show?id=4ba395994d' target=_blank style='color:#2F92EE;'>#II期临床#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9599, encryptionId=4ba395994d, topicName=II期临床)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=139811614978, createdName=guihongzh, createdTime=Wed Jul 11 06:51:00 CST 2018, time=2018-07-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1588008, encodeId=7dfd1588008a0, content=<a href='/topic/show?id=056095e171' target=_blank style='color:#2F92EE;'>#III期临床试验#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9571, encryptionId=056095e171, topicName=III期临床试验)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d24217580122, createdName=guihongzh, createdTime=Wed Jul 11 06:51:00 CST 2018, time=2018-07-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1594524, encodeId=689a159452442, content=<a href='/topic/show?id=b317956200' target=_blank style='color:#2F92EE;'>#III期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9562, encryptionId=b317956200, topicName=III期)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智智灵药, createdTime=Wed Jul 11 06:51:00 CST 2018, time=2018-07-11, status=1, ipAttribution=)]
    2018-10-16 juliusluan78
  5. 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replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9550, encryptionId=c5a89550ff, topicName=III)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e68e415, createdName=juliusluan78, createdTime=Tue Oct 16 17:51:00 CST 2018, time=2018-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1931438, encodeId=4b9a193143821, content=<a href='/topic/show?id=a3d89601f2' target=_blank style='color:#2F92EE;'>#II期临床试验#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9601, encryptionId=a3d89601f2, topicName=II期临床试验)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Sat Apr 20 05:51:00 CST 2019, time=2019-04-20, status=1, ipAttribution=), 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  6. 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  7. 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encryptionId=056095e171, topicName=III期临床试验)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d24217580122, createdName=guihongzh, createdTime=Wed Jul 11 06:51:00 CST 2018, time=2018-07-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1594524, encodeId=689a159452442, content=<a href='/topic/show?id=b317956200' target=_blank style='color:#2F92EE;'>#III期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9562, encryptionId=b317956200, topicName=III期)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智智灵药, createdTime=Wed Jul 11 06:51:00 CST 2018, time=2018-07-11, status=1, ipAttribution=)]
    2018-07-11 lmm397
  8. 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  9. 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全身型幼年特发性关节炎合并巨噬细胞活化综合征的诊治进展

幼年特发性关节炎(JIA):持续6周或6周以上的单关节或多关节炎,16岁以前起病,并除外其他已知原因的一类疾病。

J Rheumatol:临床不活动的幼年特发性关节炎的急性发作与超声结果不相关

这项研究表明,将近一半CID患儿的8个常见受累关节中有1个存在超声异常。这些发现与随后2年随访中的临床急性发作无关。

J Rheumatol:幼年特发性关节炎患者依那西普停药后急性发作的预测因子

相当大比例维持CID至少6个月的JIA患者在ETN停药后复发。男性、ANA阳性和基线CRP升高与急性发作风险升高相关。

Arthritis Rheumatol:阿巴西普治疗多关节型幼年特发性关节炎的III期研究

根据体重分层的SC阿巴西普在不同年龄和体重组达到了目标剂量,耐受性良好,并在24个月内改善了pJIA症状。

2018 国际工作小组建议:幼年特发性关节炎的目标治疗

近期幼年特发性关节炎的治疗进展已经可使大多数患者达到缓解,达到这个目标可改善治疗结局,本文主要针对幼年特发性关节炎的目标治疗提供指导建议,共涉及6条总体原则和8条建议。

J Rheumatol:幼年特发性关节炎颞下颌关节内异位骨形成的危险因素

接受IAC注射治疗TMJ关节炎的JIA患者中,TMJ内的HBF相对常见。