Paediatric patients with inflammatory bowel disease who received infliximab experienced improved growth and bone health.
OBJECTIVE
Children with inflammatory bowel disease (IBD) have a high prevalence of growth retardation and low bone mineral density (BMD). This retrospective study investigated whether the start of infliximab treatment (IFX) was associated with improvement of growth and bone health.


METHODS
Anthropometry, BMD and bone markers were measured 1 year before and after the start of IFX treatment in 33 patients (51% males), with a median age of 13.5 years at baseline. Outcomes were growth with treatment and indicators of improved bone health.


RESULTS
Twenty-one children (64%) experienced a positive catch-up growth after IFX. Height standard deviation scores (SDS) were significantly higher in children in remission. Treatment with IFX was associated with a statistically significant increase in 25-hydroxycholecalciferol (25-OHD, p = 0.01). IFX had no influence on BMD. Children with low BMD < -2 had significantly higher inflammation scores, lower body mass index, weight, height SDS and 25-ODH after IFX.


CONCLUSIONS
After treatment with IFX, children with IBD improved significantly in weight, with the majority achieving positive catch-up growth. Bone mass tended to remain static with time of treatment with IFX, despite a significant increase in 25-OHD. Improved nutritional status positively predicts improved bone mineralisation.
Department of Paediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria.
Judith
J
Pichler
Andreas
A
Hanslik
Wolf Dietrich
WD
Huber
Christoph
C
Aufricht
Bettina
B
Bidmon-Fliegenschnee
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000494:pharmacology* / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000494:pharmacology* / Q000627:therapeutic use; D015519:Bone Density / Q000187:drug effects*; D001842:Bone and Bones / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D005260:Female; D006128:Growth / Q000187:drug effects*; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy / Q000503:physiopathology*; D000069285:Infliximab; D007262:Infusions, Intravenous; D008297:Male; D012189:Retrospective Studies; D015430:Weight Gain / Q000187:drug effects
D000305:Adrenal Cortex Hormones; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000911:Antibodies, Monoclonal; D000069285:Infliximab
Bone health; Bone mineral density; Children; Inflammatory bowel disease; Infliximab