Effect Of Tozizumab On Systemic Juvenile Idiopathic Arthritis

Objective:To observe the clinical and laboratory characteristics of Tocilizumab(TCZ)in the treatment of children with systemic Juvenile Idiopathic Arthritis(sJIA),and to explore its efficacy and safety.Methods:32 sJIA patients treated with Tocilizumab in the Pediatric Center of the First Affiliated Hospital of Xinjiang Medical University from January 2019 to December 2022 were selected as the subjects.Clinical manifestations(fever,rash,number of joint swelling and pain,stc.),disease activity(JADAS27 score)and adverse drug reactions were collected and analyzed before treatment,1month,3month,5month,and 12months after treatment.To investiqate the efficacy and safety of TCZ in sJIA.All children were treated with nonsteroidal anti-inflammatory drugs(NSAIDs),palliative antirheumatic drugs(DMARDs),glucocorticoid(GC)and other traditional drugs before or at the same time.Results:A retrospective analysis of 32children with sJIA showed that fever(32,100%),arthritis(29,91%)and rash(17,53%)were the main clinical triad manifestations.Erythrocyte sedimentation rate,C-reactive protein,IL-6,IL17,TNF-a were significantiy increased by laborarory tests.Compared with before treatment,clinical symptoms and laboratory inflammation indexes wre significantly decreased atl month,3 months,6 months and 12months after treatment(<0.05);Hemoglobin increased significantly(<0.05)after 3 months of treatment.JADAS27 decreased significantlys after 1 month,3 months,6 months and 12months compared with before treatment,with statistical significance(<0.05).After 1 month of treatment,8 cases had more than 50%remission of cinical aymptoms;after 3 months of treatment,5cases had achieved clinical remission(CR)and 8 cases had achieved low disease activity(LDA),the total effective rate wae 40.6%.In the whole follow-up process,clinical efficacy was determined to be effective in 20cases,partially effective in 7cases,and ineffective in 5 cases.10 cases had successfully reduced hormone,and 5cases had changed biological agents.The adverse effects of TCZ treatment included upper respiratory tract infection,gastrointestinal infection,pneumonia,elevated transaminase and neutrophilic granulocyte.Conclusion:Tozizumab has god efficacy,high safe and mild adverse reactions in the treatment of sJIA.It can alleviate clinical symptoms in the short term,reduce laboratory indicators and reduce activity,and can achieve long-term clinical remission.