title: Effect of tocilizumab on growth impairment in systemic juvenile idiopathic arthritis with long-term corticosteroid therapy.
abstract: BACKGROUND
  The safety and efficacy of tocilizumab (TCZ), an anti-IL-6 receptor monoclonal antibody, have been reported in the treatment of children with systemic juvenile idiopathic arthritis (sJIA).
  
  
  OBJECTIVE
  Growth of children during the TCZ study was analyzed.
  
  
  METHODS
  Forty-five sJIA patients (8.1 ± 4.2 years) were enrolled. Mean standard deviation score (SDS) for height (HTSDS), height velocity (HVSDS) and changes in SDS from baseline (∆SDS) were determined. Correlation between ∆SDS and several factors such as age, disease duration and corticosteroid exposure were evaluated. Yearly height velocity was analyzed for 28 patients for whom we had data for 1 year prior to TCZ administration and who had received TCZ for more than 1 year.
  
  
  RESULTS
  Of the 45 patients, 38 (84%) obtained a clinical response at week 144. The mean baseline HTSDS was - 2.7 ± 2.0 and inversely correlated with disease duration. Significant improvement was seen in change in HVSDS from 1 year prior to 1 year after baseline (- 6.0 ± 4.0 to - 2.5 ± 3.9, p = 0.0064). Reduction in corticosteroid exposure was significantly associated with improvement in HVSDS (p = 0.0027).
  
  
  CONCLUSIONS
  Growth impairment evidenced by HTSDS was more prominent in patients with longer standing disease. Catch-up growth was observed in patients who required less or no corticosteroid during TCZ treatment.
authors.affiliation: Department of Pediatrics, Yokohama City University , Yokohama , Japan.
authors.forename: Takako
authors.initials: T
authors.lastname: Miyamae
authors.forename: Susumu
authors.initials: S
authors.lastname: Yokoya
authors.forename: Hisashi
authors.initials: H
authors.lastname: Yamanaka
authors.forename: Shumpei
authors.initials: S
authors.lastname: Yokota
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000009:adverse effects / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001171:Arthritis, Juvenile / Q000150:complications / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006130:Growth Disorders / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D008297:Male; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; C502936:tocilizumab
keywords: Growth impairment; IL-6; JIA; Tocilizumab