Growth failure is rare in a contemporary cohort of paediatric inflammatory bowel disease patients. (20th August 2020)

• Record Type: Journal Article
• Authors: Ashton, James J.; Green, Zachary; Young, Aneurin; Borca, Florina; Coelho, Tracy; Batra, Akshay; Afzal, Nadeem A.; Ennis, Sarah; Johnson, Mark J.; Beattie, R. Mark
• Is Part Of: Acta pædiatrica. Volume 110:Number 1(2021)
• Page Start: 326
• Page End: 334
• Publication Date: 2020-08-20
• Subjects: anti‐TNF -- Crohn's disease -- growth -- height -- inflammatory bowel disease -- paediatric -- weight; Pediatrics -- Periodicals; Pediatrics; 618.92
• DOI: 10.1111/apa.15383
• Languages: English
• ISSNs: 0803-5253

Abstract

Abstract: Aim: We assessed growth in a paediatric inflammatory bowel disease (PIBD) cohort. Methods: Paediatric inflammatory bowel disease patients were eligible if they were diagnosed at Southampton Children's Hospital from 2011 to 2018. Weight and height standard deviation scores (SDS) were retrieved. Mean SDS values, SDS change and anti‐TNF status were analysed at diagnosis and during follow‐up. Results: Four hundred and ninety patients were included, 313 with Crohn's disease (CD). CD patients presented with mean height SDS −0.13, −0.1 at 1‐year, −0.11 at 2‐years and −0.03 at 5 years, reflecting preserved linear growth. There was no significant height‐SDS change from diagnosis to 5‐year follow‐up, +0.12, 95%‐CI: 0.48 to −0.24. Mean weight‐SDS at diagnosis was −0.39, driven by CD patients (−0.65). Mean weight‐SDS approached 0 after 1 year and remained at the 50th centile throughout follow‐up. Growth in ulcerative colitis was maintained. In multivariable regression males had worse height growth from diagnosis to transition ( P = .036). Anti‐TNF treatment ( P = .013) and surgical resection ( P = .005) were also associated with poorer linear growth. Patients treated with anti‐TNF therapy had lower height‐SDS compared to those never treated with anti‐TNF at 1 year (−0.2 vs −0.01, P = .22), 2‐years (−0.27 vs −0.01, P = .07) and 5 years (−0.21 vs 0.25, P = .051). Conclusion: Height was generally maintained in Crohn's disease, and impaired linear growth was rare in this cohort.