title: The effects of anti-TNF-α treatment with adalimumab on growth in children with Crohn's disease (CD).
abstract: BACKGROUND
  Adalimumab is used to treat children with Crohn's disease (CD), but the effects of adalimumab on growth in CD have not been studied.
  
  
  OBJECTIVE
  To study growth and disease activity over 12 months (6 months prior to (T-6), baseline (T0) and for 6 months following (T+6) adalimumab).
  
  
  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 (ΔHtSDS) increased from -0.2 (-0.9, 1.0) at T0 to 0.2 (-0.6, 1.6) at T+6, (p=0.007)), (ii) in those who were on immunosuppression ΔHtSDS increased from -0.2 (-0.9, 1.0) at T0 to 0.1 (-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 ΔHtSDS increased significantly from -0.3 (-0.9, 1.0) at T0 to 0.3 (-0.5, 1.6) at T+6, (p=0.02). Median ΔHtSDS also increased from -0.4 (-0.8, 0.7) at T0 to 0.0 (-0.6, 1.6) at T+6, (p=0.04) in 15 children who were on prednisolone therapy when starting adalimumab.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Bone & Endocrine Research Group Royal Hospital for Sick Children, Yorkhill, Glasgow, UK.
authors.forename: S
authors.initials: S
authors.lastname: Malik
authors.forename: S F
authors.initials: SF
authors.lastname: Ahmed
authors.forename: M L
authors.initials: ML
authors.lastname: Wilson
authors.forename: N
authors.initials: N
authors.lastname: Shah
authors.forename: S
authors.initials: S
authors.lastname: Loganathan
authors.forename: S
authors.initials: S
authors.lastname: Naik
authors.forename: B
authors.initials: B
authors.lastname: Bourke
authors.forename: A
authors.initials: A
authors.lastname: Thomas
authors.forename: A K
authors.initials: AK
authors.lastname: Akobeng
authors.forename: A
authors.initials: A
authors.lastname: Fagbemi
authors.forename: D C
authors.initials: DC
authors.lastname: Wilson
authors.forename: R K
authors.initials: RK
authors.lastname: Russell
mesh_terms: D000068879:Adalimumab; D000293:Adolescent; D000893:Anti-Inflammatory Agents / Q000494:pharmacology / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000494:pharmacology / Q000627:therapeutic use*; D001827:Body Height / Q000187:drug effects; D002648:Child; D003424:Crohn Disease / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D011239:Prednisolone / Q000627:therapeutic use; D011627:Puberty / Q000187:drug effects; D012074:Remission Induction; D018709:Statistics, Nonparametric; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D000893:Anti-Inflammatory Agents; D061067:Antibodies, Monoclonal, Humanized; D007166:Immunosuppressive Agents; D014409:Tumor Necrosis Factor-alpha; D011239:Prednisolone; D000068879:Adalimumab; D008727:Methotrexate