title: Growth and Adult Height in Patients with Crohn's Disease Treated with Anti-Tumor Necrosis Factor α Antibodies.
abstract: Inflammation contributes to growth failure associated with inflammatory bowel diseases. Anti-TNFα therapy induces sustained remission and short-term improvements in height velocity and/or height standard deviation score (H-SDS) patients with Crohn's disease. The purpose of this study was to evaluate growth and adult height in patients with Crohn's disease taking maintenance infliximab or adalimumab therapy.This university-hospital based retrospective study included 61 patients, with a median follow-up of 2.6 years (2.0; 3.3). 38 patients (62%) reached their adult height. H-SDS was collected at diagnosis and together with disease activity markers (Harvey-Bradshaw Index, albumin, and C-reactive protein) at treatment initiation (baseline), and follow-up completion. Wilcoxon's signed-rank test was chosen for comparisons. Median H-SDS decreased from diagnosis to baseline (-0.08 [-0.73; +0.77] to -0.94 [-1.44; +0.11], p<0.0001) and then increased to follow-up completion (-0.63 [-1.08; 0.49], p = 0.003 versus baseline), concomitantly with an improvement in disease activity. Median adult H-SDS was within the normal range (-0.72 [-1.25; +0.42]) but did not differ from baseline H-SDS and was significantly lower than the target H-SDS (-0.09 [-0.67; +0.42], p = 0.01). Only 2 (6%) males had adult heights significantly below their target heights (10.5 and -13.5 cm [-1.75 and -2.25 SD]). In conclusion, anti-tumor necrosis factor α (TNF) therapy prevented loss of height without fully restoring the genetic growth potential in this group of patients with CD. Earlier treatment initiation might improve growth outcomes in these patients.
authors.affiliation: Service de Gastroentérologie Pédiatrique, Assistance publique-Hôpitaux de Paris, Hôpital Robert Debré, Paris, France.
authors.forename: Sarah
authors.initials: S
authors.lastname: Bamberger
authors.affiliation: Service de Gastroentérologie Pédiatrique, Assistance publique-Hôpitaux de Paris, Hôpital Robert Debré, Paris, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Martinez Vinson
authors.affiliation: Unité d'Epidémiologie Clinique, Assistance publique-Hôpitaux de Paris, Hôpital Robert Debré, Paris, France.|Centre d'Investigation Clinique-Epidémiologie Clinique Unité 1426, Institut National de la Santé et de la Recherche Médicale (Inserm), Paris, France.
authors.forename: Damir
authors.initials: D
authors.lastname: Mohamed
authors.affiliation: Service de Gastroentérologie Pédiatrique, Assistance publique-Hôpitaux de Paris, Hôpital Robert Debré, Paris, France.
authors.forename: Jérôme
authors.initials: J
authors.lastname: Viala
authors.affiliation: Service d'Endocrinologie Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Assistance publique-Hôpitaux de Paris, Hôpital Robert Debré, Paris, France.|Université Paris Diderot, Sorbonne Paris Cité, Paris, France.|Institut National de la Santé et de la Recherche Médicale (Inserm), Unité 1141, DHU Protect, Paris, France.
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Carel
authors.affiliation: Service de Gastroentérologie Pédiatrique, Assistance publique-Hôpitaux de Paris, Hôpital Robert Debré, Paris, France.|Institut National de la Santé et de la Recherche Médicale (Inserm), Centre de Recherche sur l'Inflammation Unité 1149, Paris, France.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Hugot
authors.affiliation: Service d'Endocrinologie Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Assistance publique-Hôpitaux de Paris, Hôpital Robert Debré, Paris, France.|Institut National de la Santé et de la Recherche Médicale (Inserm), Unité 1141, DHU Protect, Paris, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Simon
mesh_terms: D000068879:Adalimumab / Q000627:therapeutic use*; D000293:Adolescent; D001827:Body Height; D002648:Child; D003424:Crohn Disease / Q000188:drug therapy / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006128:Growth; D006801:Humans; D000069285:Infliximab / Q000627:therapeutic use*; D008297:Male; D012189:Retrospective Studies; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors* / Q000276:immunology
chemical_list: D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D000068879:Adalimumab