ESPEYB15 9 Oncology and chronic disease Growth, growth hormone and puberty in chronic diseases: novel insights from clinical practice (4 abstracts)
9.8 Growth and weight gain in children with juvenile idiopathic arthritis: results from the ReACCh-Out cohort
Guzman J , Kerr T , Ward LM , Ma J , Oen K , Rosenberg AM , Feldman BM , Boire G , Houghton K , Dancey P , Scuccimarri R , Bruns A , Huber AM , Watanabe Duffy K , Shiff NJ , Berard RA , Levy DM , Stringer E , Morishita K , Johnson N , Cabral DA , Larché M , Petty RE , Laxer RM , Silverman E , Miettunen P , Chetaille AL , Haddad E , Spiegel L , Turvey SE , Schmeling H , Lang B , Ellsworth J , Ramsey SE , Roth J , Campillo S , Benseler S , Chédeville G , Schneider R , Tse SML , Bolaria R , Gross K , Feldman D , Cameron B , Jurencak R , Dorval J , LeBlanc C , St Cyr C , Gibbon M , Yeung RSM , Duffy CM & Tucker LB
British Columbia Children’s Hospital and University of British Columbia, Vancouver, Canada
To read the full abstract: Pediatr Rheumatol Online J. 2017Aug 22;15(1):68
This large prospective study analysed growth in children with JIA during a 3-year period from diagnosis. Interesting findings emerge: the heights and weights of these patients, clearly compromised in historical cohorts, appeared nearly normal. Increased risk of growth impairment was noted in patients with systemic arthritis, due to the more frequent use of systemic steroids. This study used limited analyses of growth. For example, the authors used a change of 1.0 Z-scores relative to baseline to indicate growth impairment, however this cut-off could include normal periods of relative stasis or rapid growth. Moreover, a child who was obese at baseline and reduced by 1.0 BMI Z-scores during follow-up, becoming closer to his/her ideal BMI, was defined as having “poor weight gain”, instead of “desirable weight loss”. Furthermore, the reported growth impairment, estimated in a 3-year period, may be transitory and final height and weight may be unaffected due to delayed puberty and late growth spurt. Most children had not completed their growth at the last assessment, and data on target heights were unavailable. Furthermore, these data may be no longer so relevant. The 2013 update of the American College of Rheumatology juvenile arthritis treatment recommendations (1) include initial monotherapy with biologics as an option in children with systemic arthritis.
1. Ringold S, Weiss PF, Beukelman T, Dewitt EM, Ilowite NT, Kimura Y, Laxer RM, Lovell DJ, Nigrovic PA, Robinson AB, Vehe RK; American College of Rheumatology. 2013 update of the 2011 American College of Rheumatology recommendations for the treatment of juvenile idiopathic arthritis: recommendations for the medical therapy of children with systemic juvenile idiopathic arthritis and tuberculosis screening among children receiving biologic medications. Arthritis Care Res (Hoboken). 2013; 65: 1551-1563.
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ESPE Yearbook of Paediatric Endocrinology
ISSN 1662-4009 (Online)
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