Background: Juvenile idiopathic arthritis (JIA) is a heterogeneous group of diseases associated with an increase of inflammatory cytokines that may to influence child growth. However this is already known, to date auxological data published of JIA patients during biologic treatment are incomplete and very heterogeneous.
Objective and hypotheses: To evaluate the auxological features in a selected cohort of patients with JIA treated with biologic drugs.
Method: This single-center retrospective study have evaluated 43 children (22 with polyarticular and 21 with oligoarticular JIA onset) long-term treated with biologics and compared with 86 age and sex-matched healthy controls. Patients with endocrinological or other chronic comorbid conditions or long-term steroid treatments were excluded at the beginning.
Results: All patients received antiTNFalpha treatment; nine patients received CTLA-4Ig; one patient received anti-IL6. Fifteen patients received >1 biologics. The median height SDS at JIA diagnosis was −0.57±0.80 vs 0.09±0.84 SDS of controls (P<0.0001) (−0.45±0.85 SDS for oligoarticular (P<0.05) and −0.73±0.72 SDS for polyarticular (P<0.0001)). The target height SDS was not statistically different (0.02±0.66 vs 0.05±0.79 SDS). After disease modifying antirheumatic drugs (DMARDs) and at biologic therapy onset the height was −0.4±0.98 SDS vs 0.14±0.86 of controls (P<0.005) (−0.37±0.95 SDS (P<0.05) for oligoarticular and −0.43±1.03 SDS (P<0.05) for polyarticular). After a follow-up of 7.61±2.43 years height SDS was −0.28±1.02 vs 0.08±0.81 SDS (P<0.05) (−0.19±0.96 SDS (p=NS) for oligoarticular and −0.37±1.09 SDS (P<0.05) for polyarticular). The Δheight during biologics treatment was statistically significant considering the all JIA group and oligoarticular (P<0.0001) but not polyarticular onset vs. controls and between oligoarticular and polyarticular onset (P<0.0001).
Conclusions: Long-term biologic treatments may cause a significant increase of height SDS in JIA patients. However, polyarticular onset JIA may not ameliorate their height SDS despite the obvious clinical improvement of the disease.
10 - 12 Sep 2016
European Society for Paediatric Endocrinology