Efficacy of TNF blockers from the perspective of growth velocity: slovak experience

Abstract

Introduction: In patients with polyarticular course of juvenile idiopathic arthritis (JIA) both, ongoing chronic inflammation with high levels of proinflammatory cytokines and corticosteroid treatment, may affect linear growth adversely, potentially leading to irreversible growth retardation. Biologic treatment of JIA may have the potential to enable normal growth in children with JIA. Objectives: To retrospectively evaluate clinical efficacy, from perspective of growth velocity as a sensitive marker of well-being in children, of biologics in children with JIA in both centers in Slovakia. Methods: 34 patients (17 girls, 17 boys) with DMARDs-resistant polyarticular JIA receiving TNFa blocker (28 etanercept, 6 adalimumab) + methotrexate were evaluated during their first year of biologic therapy. The mean age at anti-TNF treatment initiation was 10.52 (range 2.98-17.77). Median duration of disease was 4.42 years (range 0.89-10.63), 24 patients received corticosteroids. Control group, consisted of 21 patients (12 boys, 9 girls) with polyarticular course of JIA non-responsive to NSAIDs therapy and intraarticular corticosteroid injections, was evaluated during their first year of DMARDs treatment. Same inclusion and exclusion criteria, e.g. age and Tanner staging, were applied for both groups. Growth velocity was defined by change of height in standard deviation score (SDS). A positive value >0.1 indicated catch-up and negative value