Advances in the application of tumor necrosis factor inhibitors in juvenile idiopathic arthritis
10.3760/cma.j.issn.1673-4408.2025.08.004
- VernacularTitle:肿瘤坏死因子抑制剂在幼年特发性关节炎中的应用进展
- Author:
Mengyao YU
1
;
Wei ZHANG
Author Information
1. 电子科技大学医学院附属妇女儿童医院 成都市妇女儿童中心医院儿童风湿免疫科 610091
- Keywords:
Tumor necrosis factor inhibitors;
Juvenile idiopathic arthritis;
Efficacy;
Safety
- From:
International Journal of Pediatrics
2025;52(8):520-525
- CountryChina
- Language:Chinese
-
Abstract:
Juvenile idiopathic arthritis（JIA）is a pediatric rheumatic disease characterized by chronic arthritis as its core manifestation，with pathogenesis closely linked to inflammatory responses mediated by pro-inflammatory factors such as tumor necrosis factor alpha（TNF-α）. Tumor necrosis factor inhibitors（TNFi）have significantly improved disease activity and prognosis in JIA patients by targeting and blocking inflammatory pathways. Commonly used TNFi agents，including etanercept，infliximab，adalimumab，and golimumab，have demonstrated favorable efficacy in multiple studies. However，infection risks-particularly the increased risk of tuberculosis associated with TNFi require heightened attention，necessitating pre-treatment screening and ongoing monitoring. The immunogenicity of these agents may also impact long-term therapeutic outcomes. Monoclonal antibody-based TNFi agents demonstrate superior efficacy in JIA patients with concomitant uveitis，whereas fusion protein TNFi show limited therapeutic benefits. Vaccination with live vaccines should be avoided，whereas inactivated vaccines generally demonstrate satisfactory immunogenicity. This review summarizes the efficacy，safety，and current research status of TNFi in JIA treatment，explores limitations of existing studies，and aims to advance precision medicine for JIA，optimize clinical practice，and provide direction for future research.
