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

详细信息    查看全文

• 作者：S. Malik^a ; ^b ; S.F. Ahmed^a ; M.L. Wilson^c ; N. Shah^d ; S. Loganathan^e ; S. Naik^f ; B. Bourke^g ; A. Thomas^h ; A.K. Akobeng^h ; A. Fagbemi^h ; D.C. Wilson^c ; R.K. Russell^b ; ^{richardrussell@nhs.net}
• 关键词：Adalimumab ; Growth ; Inflammatory bowel disease ; Crohn's disease
• 刊名：Journal of Crohn's and Colitis
• 出版年：2012
• 出版时间：April, 2012
• 年：2012
• 卷：6
• 期：3
• 页码：337-344
• 全文大小：511 K

文摘

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 ?#xA0;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 (¦¤HtSDS) increased from ?#xA0;0.2 (?#xA0;0.9, 1.0) at T0 to 0.2 (?#xA0;0.6, 1.6) at T + 6, (p = 0.007)), (ii) in those who were on immunosuppression ¦¤HtSDS increased from ?#xA0;0.2 (?#xA0;0.9, 1.0) at T0 to 0.1 (?#xA0;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 ¦¤HtSDS increased significantly from ?#xA0;0.3 (?#xA0;0.9, 1.0) at T0 to 0.3 (?#xA0;0.5, 1.6) at T + 6, (p = 0.02). Median ¦¤HtSDS also increased from ?#xA0;0.4 (?#xA0;0.8, 0.7) at T0 to 0.0 (?#xA0;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.