A commentary on TREAT: the trial of early aggressive drug therapy in juvenile idiopathic arthritis.
A commentary on TREAT: the trial of early aggressive drug therapy in juvenile idiopathic arthritis.
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DOI：
10.1186/1741-7015-10-59
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发表时间：
2012-06-13
期刊：
影响因子：
9.3
通讯作者：
Baildam E
中科院分区：
文献类型：
--
作者：
Baildam E
多关节幼年特发性关节炎（JIA）是一种JIA，其中多个关节受到慢性炎症的影响，并且在未经治疗的疾病中，关节的严重和持久损伤是预期的自然史。有证据表明，缓解疾病的抗风湿药物和生物药物的反应，但很少有证据表明，从任何现有的治疗试验永久缓解。华莱士等人的TREAT试验，最近发表在《关节炎和风湿病》杂志上的一项研究，使用多中心协作方法研究多关节JIA的早期积极治疗，试图在治疗6个月后达到完全临床非活动性疾病。该研究的主要发现是，在病程中越早开始治疗，疾病控制的机会就越好，这提供了证据，证明治疗JIA的“机会之窗”就像治疗成人类风湿性关节炎（RA）一样。这项研究为未来的治疗试验提供了一个平台和动力，集中在早期而不是确定的疾病上，并调查在10至12周内开始治疗的标准。
Polyarticular juvenile idiopathic arthritis (JIA) is a category of JIA where multiple joints are affected by chronic inflammation, and where serious and lasting damage to joints is the expected natural history in untreated disease. There is evidence of response to disease-modifying antirheumatic and biologic drugs, but little evidence of permanent remission from any of the existing therapeutic trials. The TREAT trial by Wallace et al., recently published in Arthritis and Rheumatism, used a collaborative multicenter approach to studying early aggressive treatment of polyarticular JIA in an attempt to achieve full clinical inactive disease after 6 months of treatment. The study's main finding that the earlier in the disease course that treatment is started, the better the chance of disease control, has provided evidence that there is a 'window of opportunity' for treating JIA as there is in adult rheumatoid arthritis (RA). The study provides both a platform and an impetus for concentrating future treatment trials on early rather than established disease and investigating a standard of starting treatment within 10 to 12 weeks.
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