Analysis Of The Effect Of Tocilizumab In The Treatment Of Systemic Juvenile Idiopathic Arthritis At Different Dosing Intervals

ObjectiveCompare the short-term effect of the treatment of systemic juvenile idiopathic arthritis with different administration intervals of tocilizu-mab,and provide clinical reference for the selection of appropriate treatment regimen.Methods45 children with active sJIA were selected from the first affiliated hospital of Zhengzhou university as study subjects,from January 2015 to September 2017.According to the different therapeutic regimen,the children were divided into three groups: traditional treatment group,group A,and group B(15 cases each).Traditional treatment group was treated with traditional antirheumatic drugs(methotrexate+ prednisone+voltaren).Group A was treated with tocilizumab(≥ 30 kg,8 mg / kg;< 30 kg,12 mg / kg;once every 4 weeks)on the basis of traditional treatment.Group B was treated with tocilizumab(≥ 30 kg,8 mg / kg;< 30 kg,12 mg / kg;once every 2 weeks)on the basis of traditional treatment.Compared the changes of laboratory indexes(CRP,ESR)and clinical signs(number of active inflammatory joints,number of restricted joints)in the three groups before and after treatment.The efficacy of the drug was evaluated using the American cllege of rheumatology ACR-response standard ACR 30,ACR 50.The data were analyzed by χ2-test or ANOVA.Results(1)Compared to before treatment,the clinical signs and laboratory indexes of the three groups were improved after 4 weeks,8 weeks and 12 weeks,and the difference was statistically significant(P < 0.05).(2)The improvement of laboratory indexes in group B was better than that in traditional treatment group and group A at 12 weeks after treatment(P < 0.05).(3)The improvement of clinical signs in group A and group B was better than that in treatment group at 8,12 weeks(P < 0.05),but there was no significant difference between group A and group B.(4)The improvement rate of ACR50 in group A at week 4(P < 0.05)and ACR30,ACR50 in group A(8,12 weeks)was higher than that in traditional treatment group(P < 0.05).(5)The improvement rate of ACR30,ACR50 in group B was higher than that in traditional treatment group(P < 0.05).(6)The improvement rate of ACR30 and ACR50 ware no significant difference between group A and group B(P > 0.05).(7)There was no statistically significant difference in the incidence of adverse events in the three groups.ConclusionThe treatment of systemic juvenile idiopathic arthritis by tocilizumab with once every 4 weeks and once every 2 weeks can achieve the same therapeutic effect in the early stage.