title: Growth in children and adolescents with juvenile idiopathic arthritis over 2 years of treatment with etanercept: results from the British Society for Paediatric and Adolescent Rheumatology Etanercept Cohort Study.
abstract: OBJECTIVE
  Children with JIA can experience delayed and restricted growth. The objectives of this study were to investigate the influence of etanercept (ETN) on vertical growth and factors associated with improved growth in patients with JIA over the initial 2 years of treatment.
  
  
  METHODS
  This analysis was restricted to ETN-treated patients in the British Society for Paediatric and Adolescent Rheumatology Etanercept Cohort Study with complete height data recorded at baseline, 1 and 2 years. Height z-scores were calculated using the World Health Organization growth standards for age and gender. Change in height z-score was evaluated over time. Multivariable linear regression was used to identify factors associated with change in height z-score from baseline.
  
  
  RESULTS
  A total of 191 ETN-treated patients were included: 65% female, median baseline age 11.0 years [interquartile range (IQR) 7.3-12.9], median disease duration 3.5 years (IQR 1.7-7.1). At baseline mean height z-score was -0.74 (s.d. 1.4). After 2 years mean height z-score increased to -0.45 (1.4) (change +0.29; P < 0.001). In multivariable analysis, factors associated with an improvement in height z-score included lower baseline height z-score [-0.110 per unit (95% CI -0.161, -0.059), P < 0.001] and no oral corticosteroid use at baseline [-0.192 (95% CI -0.343, -0.040), P = 0.013].
  
  
  CONCLUSIONS
  ETN therapy was associated with an improvement in height z-score over the first 2 years of therapy in this real-world cohort of children with severe JIA. The lack of a strong association of improvements in height with improvements in disease activity warrants further exploration.
authors: Arthritis Research UK Centre for Epidemiology, University of Manchester, Manchester Academic Health Sciences Centre and Institute of Child Health, University of Birmingham and Birmingham Children's Hospital, Birmingham, UK.
authors: Lianne
authors: L
authors: Kearsley-Fleet
authors: Arthritis Research UK Centre for Epidemiology, University of Manchester, Manchester Academic Health Sciences Centre and Institute of Child Health, University of Birmingham and Birmingham Children's Hospital, Birmingham, UK.
authors: Kimme L
authors: KL
authors: Hyrich
authors: Arthritis Research UK Centre for Epidemiology, University of Manchester, Manchester Academic Health Sciences Centre and Institute of Child Health, University of Birmingham and Birmingham Children's Hospital, Birmingham, UK.
authors: Rebecca
authors: R
authors: Davies
authors: Arthritis Research UK Centre for Epidemiology, University of Manchester, Manchester Academic Health Sciences Centre and Institute of Child Health, University of Birmingham and Birmingham Children's Hospital, Birmingham, UK.
authors: Mark
authors: M
authors: Lunt
authors: Arthritis Research UK Centre for Epidemiology, University of Manchester, Manchester Academic Health Sciences Centre and Institute of Child Health, University of Birmingham and Birmingham Children's Hospital, Birmingham, UK t.r.southwood@bham.ac.uk.
authors: Taunton R
authors: TR
authors: Southwood
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000009:adverse effects; D018501:Antirheumatic Agents / Q000494:pharmacology* / Q000627:therapeutic use*; D001171:Arthritis, Juvenile / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D001827:Body Height / Q000187:drug effects* / Q000502:physiology; D002648:Child; D015331:Cohort Studies; D004305:Dose-Response Relationship, Drug; D000068800:Etanercept; D005260:Female; D006128:Growth / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D007074:Immunoglobulin G / Q000494:pharmacology* / Q000627:therapeutic use*; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use*; D012015:Reference Standards; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D006113:United Kingdom / Q000453:epidemiology; D014944:World Health Organization
chemical_list: D000305:Adrenal Cortex Hormones; D018501:Antirheumatic Agents; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D000068800:Etanercept
keywords: biologic therapies; epidemiology; juvenile idiopathic arthritis