Clinical study of infliximab in treatment of patients with juvenile idiopathic arthritis
10.3760/cma.j.issn.2095-428X.2014.09.005
- VernacularTitle:英夫利昔单抗治疗幼年特发性关节炎的疗效
- Author:
Juan ZHOU
;
Yu ZHANG
;
Yuan DING
;
Zhiyong ZHANG
;
Xuemei TANG
- Publication Type:Journal Article
- Keywords:
Juvenile idiopathic arthritis;
Infliximab;
Therapy
- From:
Chinese Journal of Applied Clinical Pediatrics
2014;29(9):655-658
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the clinical efficacy,adverse effect and prognosis of infliximab in treatment of the patients with juvenile idiopathic arthritis (JIA).Methods Thirty-two cases of infliximab-treated JIA patients and 30 cases of JIA control patients were investigated in this prospective study,and their tender joint count (TJC),swollen joint count (SJC),erythrocyte sedimentation rate (ESR),C-reactive protein (CRP),visual analog scale for general health (GH),disease activity score (DAS) 28,as well as adverse reactions of treatment and follow-up outcomes were analyzed.The infliximab-treated patients were intravenously infused with infliximab at the low dose of < 5 mg/(kg · time) or the high dose of ≥ 5 mg/(kg · time) in 0,2nd,6th,14th,22nd,30th week.The JIA control patients were treated with conventional therapy.Results The treatment of infliximab ameliorated the TJC,SJC,ESR,CH,CRP and DAS28 of JIA patients.In the dynamical analysis of these clinical indexes of the infliximab-treated JIA patients,the index of SJC was found to fall firstly in the 2nd week,the indexes of TJC,ESR,CH and DAS28 were found to decline secondly at 6th week,the indexes of TJC,SJC,ESR,CRP and DAS28 continued dropping till 22nd week,and only the index of GH progressively declined to 30th week.The high-dose infliximab-treated group had lower levels of ESR,GH and CRP than the low-dose infliximab-treated group (t =2.14,3.04,2.33,P =0.04,0.01,0.04).But there were no statistical difference in TJC,SJC,DAS28 and the incidence of recent adverse reactions between the high and low infliximab dose groups.In the infliximab treated group,2 cases of patients (6.25%) failed in the therapy of infliximab;9 cases of patients (28.13%) continued therapy with infliximab to 46th-62nd week; 7 cases of patients (21.88%) stopped therapy with infliximab in the 30th week had good improvement of joint symptoms and inflammatory indexes; 14 cases of patients (43.75%) relapsed and retreated by infliximab after cease the first course of treatment; 1 case of patient died of severe chickenpox infection after therapy with infliximab was ceased.Conclusions Infliximab can alleviate the joint symptoms,inflammatory indexes and DAS28 of JIA patients,and is an effective and safe therapy for JIA patients in the short-term study.