The Effect of Adalimumab Treatment on Linear Growth in Children With Crohn Disease: A Post-hoc Analysis of the PAILOT Randomized Control Trial. Issue 2 (August 2020)

• Record Type: Journal Article
• Authors: Matar, Manar; Shamir, Raanan; Lev-Zion, Raffi; Broide, Efrat; Weiss, Batia; Ledder, Oren; Guz-Mark, Anat; Rinawi, Firas; Cohen, Shlomi; Topf-Olivestone, Chani; Shaoul, Ron; Yerushalmi, Baruch; Assa, Amit
• Is Part Of: Journal of pediatric gastroenterology and nutrition. Volume 71:Issue 2(2020)
• Publication Date: 2020-08
• Subjects: adalimumab treatment -- delayed puberty -- inflammatory bowel disease -- linear growth impairment; Children -- Nutrition -- Periodicals; Pediatric gastroenterology -- Periodicals; Infants -- Nutrition -- Periodicals; Nutrition disorders in children -- Periodicals; Child Nutrition -- Periodicals; Digestive System -- growth & development -- Periodicals; Gastrointestinal Diseases -- Periodicals; Infant Nutrition -- Periodicals; Nutrition Disorders -- Periodicals; Child; 618.923
• DOI: 10.1097/MPG.0000000000002728
• Languages: English
• ISSNs: 0277-2116

Abstract

ABSTRACT: Objectives: Growth impairment is common in children with Crohn disease (CD). We aimed to assess the effect of adalimumab (ADL) treatment on linear growth in children with CD in a post-hoc analysis of the P ediatric Crohn's Disease A dalI mumab L evel–based O ptimization T reatment randomized controlled trial. Methods: Children 6 to 17 years who responded to ADL induction were assessed consecutively for anthropometric parameters. Associations of these parameters with disease characteristics and disease activity were analyzed. Results: Overall, 66 patients completed 72 weeks of follow-up (25% girls, mean age of 15.6 ± 2.5 years). Median (interquartile range [IQR]) height z score improved from −0.6 (−1.6–0.15) at baseline to −0.33 (−1.3–0.5) at week 72 ( P = 0.005) with lesser improvement in patients with perianal disease. Similar effect was noted in children with growth potential (boys younger than 16 years, girls younger than 14 years). Median (IQR) height velocity standard deviation was −0.32 (−1.5–0.8) at week 26, and +0.11 (−1.1–1.3) at week 72. Median weight z score increased from −0.54 (−1.2–0.15) to −0.1 (−0.9–0.6), P < 0.001 and body mass index from −0.4 (−1.0–0.5) to 0.0 (−0.8–0.9), P = 0.005. Pediatric CD activity index and erythrocyte sedimentation rate at week 4 correlated negatively with height z score changes ( P = 0.043 and P = 0.048, respectively), whereas sustained clinical and biologic remission (week 4–72) were positively associated with changes in height z scores. Significant improvement in linear growth was predicted by lower pediatric CD activity index and erythrocyte sedimentation rate at the end of induction and sustained clinical remission ( P = 0.05) and sustained normal C-reactive protein ( P = 0.001) at all visits. Conclusion: In children with moderate-to-severe CD, ADL treatment had a significant effect on linear growth, with normalization of weight and body mass index ( clinicaltrials.gov no: NCT02256462).