51 research outputs found
Impact of antiâTNF treatment on growth in severe juvenile idiopathic arthritis
OBJECTIVES: To evaluate the impact of antiâtumour necrosis factor (TNF) treatment on growth and to identify the predictors for the change in growth in severe juvenile idiopathic arthritis (JIA). METHODS: Data from 71 JIA patients (43 on etanercept, 28 on infliximab) were reviewed two years before and two years on the antiâTNF treatment. The patients had polyarticular disease course (48 polyarthritis, 19 extended oligoarthritis, two systemic arthritis, and two enthesitis related arthritis). At the initiation of the antiâTNF treatment, their mean age was 9.6 years and the mean duration of JIA, 5.7 years. RESULTS: In the patients with delayed growth before antiâTNF treatment (nâ=â53), the growth velocity, measured as the change in height standard deviation score, accelerated +0.45 (95% confidence interval, 0.33 to 0.56) (p<0.001) during the antiâTNF treatment. In the patients with normal or accelerated growth before antiâTNF treatment (nâ=â18), the change in growth velocity was +0.05 (0.07 to 0.16) (pâ=â0.39). At two years on antiâTNF treatment, the growth velocity between these two groups was similar. No difference was found between the patients treated with etanercept or infliximab. A decelerating growth rate before the antiâTNF treatment was the strongest predictor for the observed increase in the growth velocity. The change in the inflammatory activity remained a significant predictor of the growth velocity even after the decrease in glucocorticoid dose was taken into account. CONCLUSIONS: In the treatment of polyarticular JIA, the antiâTNF treatment not only suppresses inflammation but also restores growth velocity
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