The effects of anti-TNF-alpha treatment with adalimumab on growth in children with Crohn's disease (CD)

S. Malik, S. F. Ahmed, M. L. Wilson, N. Shah, S. Loganathan, S. Naik, B. Bourke, A. Thomas, A. K. Akobeng, A. Fagbemi, David Wilson, R. K. Russell*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

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 (TO) 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 (Delta HtSDS) 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 Delta HtSDS increased from 0.2 (-0.9, 1.0) at TO 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 Delta HtSDS increased significantly from -0.3 (-0.9, 1.0) at TO to 0.3 (-0.5, 1.6) at T + 6, (p=0.02). Median Delta HtSDS also increased from -0.4 (-0.8, 0.7) at T0 to 0.0 (-0.6, 1.6) at 1+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. (C) 2011 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.

Original languageEnglish
Pages (from-to)337-344
Number of pages8
JournalJournal of Crohn's and Colitis
Volume6
Issue number3
DOIs
Publication statusPublished - Apr 2012

Keywords

  • Crohn's disease
  • OPEN-LABEL
  • IMPROVES
  • Adalimumab
  • JUVENILE IDIOPATHIC ARTHRITIS
  • LINEAR GROWTH
  • Inflammatory bowel disease
  • Growth
  • INFLAMMATORY-BOWEL-DISEASE
  • ACTIVITY INDEX
  • LOST RESPONSE
  • INFLIXIMAB THERAPY
  • REFERENCE CURVES
  • EFFICACY

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