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Etanercept treatment improves longitudinal growth in prepubertal children with juvenile idiopathic arthritis

Paola Fernandez Vojvodich1, Jes B Hansen, Ulf Andersson

  • 1Pediatric Endocrinology Unit, Department of Woman and Child Health, Karolinska University Hospital, Stockholm, Sweden.

The Journal of Rheumatology
|December 1, 2007
PubMed

Insights

Anti-tumor necrosis factor (TNF) therapy, specifically etanercept, improved growth in most children with juvenile idiopathic arthritis (JIA). This growth enhancement occurred regardless of whether the child was undergoing puberty.

Area of Science:

  • Pediatric Rheumatology
  • Growth and Development
  • Immunomodulatory Therapies

Background:

  • Juvenile idiopathic arthritis (JIA) is a chronic inflammatory condition affecting children.
  • Anti-tumor necrosis factor (TNF) therapies are effective in managing JIA disease activity.
  • The impact of anti-TNF therapy on longitudinal growth, particularly concerning pubertal status, remains unclear.

Purpose of the Study:

  • To investigate the effect of etanercept on longitudinal growth in prepubertal and pubertal patients with JIA.
  • To assess whether growth improvement during etanercept treatment is influenced by the pubertal growth spurt.

Main Methods:

  • A cohort of 52 JIA patients treated with etanercept was analyzed.
  • Growth data, including height standard deviation scores (SDS), were collected for prepubertal (n=20) and early/midpubertal (n=11) patients over one year.
  • Changes in height SDS (DeltahSDS) were calculated to assess growth velocity and improvement.

Main Results:

  • Etanercept treatment led to a significant improvement in growth (DeltahSDS, p=0.001) in prepubertal patients.
  • Growth improvement was observed in the majority of both prepubertal (17/20) and pubertal (8/11) patients individually.
  • Improved growth correlated negatively with the need for intraarticular glucocorticoid injections (p=0.001).

Conclusions:

  • Anti-tumor necrosis factor (TNF) therapy with etanercept promotes longitudinal growth in a significant proportion of JIA patients.
  • The observed growth enhancement is independent of the pubertal growth spurt, suggesting a direct effect of TNF inhibition on growth pathways.
Abstract

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