Malik S.,Bone and Endocrine Research Group Royal Hospital for Sick Children |
Malik S.,Royal Hospital for Sick Children |
Ahmed S.F.,Bone and Endocrine Research Group Royal Hospital for Sick Children |
Wilson M.L.,University of Edinburgh |
And 9 more authors.
Journal of Crohn's and Colitis | Year: 2012
Introduction: Adalimumab is used to treat children with Crohn's disease (CD), but the effects of adalimumab on growth in CD have not been studied. Aim: To study growth and disease activity over 12. months (6. months prior to (T-6), baseline (T0) and for 6. months following (T. +. 6) adalimumab). Subjects and methods: Growth and treatment details of 36 children (M: 22) who started adalimumab at a median (10th, 90th) age of 14.7. years (11.3, 16.8) were reviewed. Results: Of 36 cases, 28 (78%) went into remission. Overall 42% of children showed catch up growth, which was more likely in: (i) those who achieved remission (median change in height SDS (δHtSDS) increased from -. 0.2 (-. 0.9, 1.0) at T0 to 0.2 (-. 0.6, 1.6) at T. +. 6, (p. =. 0.007)), (ii) in those who were on immunosuppression δHtSDS increased from -. 0.2 (-. 0.9, 1.0) at T0 to 0.1 (-. 0.8, 1.3) at T. +. 6, (p. =. 0.03) and (iii) in those whose indication for using adalimumab therapy was an allergic reaction to infliximab, median δHtSDS increased significantly from -. 0.3 (-. 0.9, 1.0) at T0 to 0.3 (-. 0.5, 1.6) at T. +. 6, (p. =. 0.02). Median δHtSDS also increased from -. 0.4 (-. 0.8, 0.7) at T0 to 0.0 (-. 0.6, 1.6) at T. +. 6, (p. =. 0.04) in 15 children who were on prednisolone therapy when starting adalimumab. Conclusion: Clinical response to adalimumab therapy is associated with an improvement in linear growth in a proportion of children with CD. Improved growth is more likely in patients entering remission and on immunosuppression but is not solely due to a steroid sparing effect. © 2011.