Effect of Biologic Treatments on Growth in Children with Juvenile Idiopathic Arthritis

Uettwiller, Florence; Perlbarg, Julie; Pinto, Graziella; Bader-Meunier, Brigitte; Mouy, Richard; Compeyrot-Lacassagne, Sandrine; Melki, Isabelle; Wouters, Carine; Prieur, Anne‐Marie; Landais, Paul; Polak, Michel; Quartier, Pierre

doi:10.3899/jrheum.130311

Cited by 26 publications

(22 citation statements)

References 27 publications

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“…In a multicenter phase IV registry study of patients with JIA treated with etanercept (with or without methotrexate), the authors concluded that etanercept may help restore normal growth . Subsequently, a retrospective study of 100 JIA patients treated with biologic agents demonstrated improved growth in a subset of patients (the systemic JIA cohort had a comparatively less favorable growth profile) . However, the data provided in those studies are difficult to interpret because of the heterogeneity of the patients (all JIA subsets were included, and those with systemic JIA represented 10–29% of the patients) and the variable treatment durations.…”

Section: Discussionmentioning

confidence: 99%

Catch‐Up Growth During Tocilizumab Therapy for Systemic Juvenile Idiopathic Arthritis: Results From a Phase III Trial

Benedetti

Brunner

Ruperto

et al. 2015

Arthritis & Rheumatology

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Section: Discussionmentioning

confidence: 99%

Catch‐Up Growth During Tocilizumab Therapy for Systemic Juvenile Idiopathic Arthritis: Results From a Phase III Trial

Benedetti

Brunner

Ruperto

et al. 2015

Arthritis & Rheumatology

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“…Recent studies suggest that early initiation of GH treatment helps in maintaining normal growth in children with JIA [34,35]. Thus, recombinant growth hormone treatment has been the mainstream since no other medications that induce skeletal growth are available to be used in pediatrics [36,37].…”

Section: Growth Delay In Chronic Inflammatory Diseasesmentioning

confidence: 99%

“…Thus, recombinant growth hormone treatment has been the mainstream since no other medications that induce skeletal growth are available to be used in pediatrics [36,37]. Nevertheless, even with GH treatment, catch-up growth is variable and is more dependent on the severity of the inflammatory state, duration, and additional corticosteroid treatment [34,[37][38][39][40][41].…”

Section: Growth Delay In Chronic Inflammatory Diseasesmentioning

confidence: 99%

Longitudinal Growth in Rheumatologic Conditions: Current and Emerging Treatments of Growth Delay in Children with Chronic Autoimmune Diseases

Bükülmez¹

2018

Newest Updates in Rheumatology

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Chronic rheumatologic, inflammatory diseases of childhood, such as juvenile idiopathic arthritis (JIA), Crohn's disease (CD), and systemic lupus erythematosus (SLE), affect both trabecular bone formation and remodeling and longitudinal bone growth resulting in short stature and causing bone developmental deformities. Inflammation alone or together with poor nutritional intake and chronic glucocorticoid therapy are major factors in growth retardation seen in children with chronic inflammatory diseases. When the growing process is continuous, acute or chronic inflammation causes dysregulation of both central endocrine and local paracrine secretion of the growth factors and hormones, impairing bone growth in children. In this chapter, we review major growth factors such as growth hormone that affect longitudinal growth and how they are affected by inflammation in childhood rheumatologic diseases. We also review a recently described growth factor, CNP, and its potential therapeutic role in chronic inflammatory diseases.

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“…Another study demonstrated a strong growth-restoring effect of anti-TNF-α in children with polyarticluar JIA, which was correlated to the decrease in disease activity, independently from corticosteroids effect [42]. However, in systemic JIA, growth restoring effect of biologic treatments seems to be less remarkable [43]. Analysis of these observations, among other therapeutic outcomes, justified the current trend of early initiation of aggressive treatment, using several combination of different agents to improve allover disease outcomes including growth [44].…”

Section: Effect Of Treatments On Growthmentioning

confidence: 99%

Growth Pattern in Children with Juvenile Idiopathic Arthritis: A Retrospective Study

Alsulami¹,

Alsulami²,

Muzaffer³

2017

OJRA

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Aim of this study is to assess growth pattern in children with juvenile idiopathic arthritis (JIA) and factors associated with growth retardation. Methods: A retrospective chart review of all cases of JIA following up at Pediatric Department of King Abdulaziz University Hospital, between July 2000 to July 2016. Demographic, clinical and biological data were collected and analyzed as risk factor for growth retardation. These included age, gender, age at diagnosis, disease duration, type of JIA, the presence of uveitis, rheumatoid factor (RF) positivity, antinuclear antibody (ANA) titer and treatment. Growth pattern was assessed as the percentile for height-for-age, weight-for-age and weight-for-height in reference to the Growth Chart for Saudi Children and Adolescents. Change in percentile rank was divided into 3 categories: regression (a drop of ≥1 percentile); stable (uphold of the same percentile); and progression (change for a superior percentile). Results: A total 78 children were eligible, 52.6% females, mean ± SD age = 9.94 ± 4.92 years, and age at diagnosis = 7.44 ± 4.52 years, mean ± SD [range] disease duration = 2.93 ± 2.70 [6 months; 15 years]. The most frequent types of JIA were systemic (33.3%), oligoarticular (30.8%) and polyarticular negative RF (26.9%). Other parameters included positive ANA in 41.0%, positive RF in 7.7% and uveitis in 9.0%. The most frequent treatment was methotrexate (59.0%), followed by biological therapy (47.4%), non-steroid anti-inflammatory drugs (43.6%) and prednisolone (33.3%). Growth data were available for 67 (85.9%) children, and assessments showed 36% cases of break of the growth curve in both height-for-age and weight-for-age percentiles and 31% in weight-for-height percentiles. In all three parameters, there were shifts towards lower percentiles from time of diagnosis to last follow-up, in both males and females. Correlation and regression analysis showed low age at diagnosis and disease duration to be significant predictors for growth retardation severity. Conclusion: One in three children with JIA has growth retardation, the severity of which is predicted by low age at disease onset and long disease duration.

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Effect of Biologic Treatments on Growth in Children with Juvenile Idiopathic Arthritis

Abstract: In a subset of patients, particularly systemic JIA patients and patients who required more than 1 biologic, biologic therapy may be insufficient to restore normal growth velocity.

Cited by 26 publications

References 27 publications

Catch‐Up Growth During Tocilizumab Therapy for Systemic Juvenile Idiopathic Arthritis: Results From a Phase III Trial

Catch‐Up Growth During Tocilizumab Therapy for Systemic Juvenile Idiopathic Arthritis: Results From a Phase III Trial

Longitudinal Growth in Rheumatologic Conditions: Current and Emerging Treatments of Growth Delay in Children with Chronic Autoimmune Diseases

Growth Pattern in Children with Juvenile Idiopathic Arthritis: A Retrospective Study

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