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The effect of penicillamine on growth as height in juvenile chronic polyarthritis
1MRC Rheumatism Unit, Canadian Red Cross Memorial Hospital, Taplow, Buckinghamshire.
Insights
Penicillamine therapy allows children with Still's disease to resume growth when their condition improves. It does not hinder growth spurts after corticosteroid withdrawal or during alternate-day steroid use.
Area of Science:
- Pediatric Rheumatology
- Pharmacology
- Growth and Development
Background:
- Still's disease, a form of juvenile idiopathic arthritis, can significantly impair growth in children.
- Growth deficits are often associated with disease activity and corticosteroid treatment.
Purpose of the Study:
- To evaluate the effect of penicillamine on growth in children with active Still's disease.
- To determine if penicillamine interferes with growth during or after corticosteroid therapy.
Main Methods:
- Observational study assessing growth parameters in children treated with penicillamine.
- Comparison of growth trajectories during active disease, penicillamine therapy, and corticosteroid withdrawal/alternate-day use.
Main Results:
- Resumption of growth was observed when disease activity improved with penicillamine.
- Penicillamine did not negatively impact growth spurts following corticosteroid withdrawal.
- Continued slow growth was maintained during alternate-day corticosteroid therapy with penicillamine.
Conclusions:
- Penicillamine can facilitate growth recovery in children with Still's disease as their condition improves.
- Penicillamine is a safe therapeutic option regarding growth, even when combined with or following corticosteroid treatment.
Abstract:
When the disease state improves during penicillamine therapy, resumption of growth occurs; if activity persists despite therapy, the expected fall-off in growth due to active Still's disease continues. Penicillamine does not interfere with the growth spurt after withdrawal of corticosteroid therapy or with the maintained slow growth during alternate-day steroid therapy.