Paediatric patients with inflammatory bowel disease who received infliximab experienced improved growth and bone
Judith Pichler1, Andreas Hanslik, Wolf Dietrich Huber
1Department of Paediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria.
Insights
Infliximab (IFX) treatment improved weight and catch-up growth in children with inflammatory bowel disease (IBD). However, bone mineral density remained static, despite increased vitamin D levels.
Area of Science:
- Pediatric Gastroenterology
- Inflammatory Bowel Disease Research
- Bone Metabolism Studies
Background:
- Children with inflammatory bowel disease (IBD) often experience growth issues and low bone mineral density (BMD).
- Understanding the impact of biologic therapies on growth and bone health is crucial for managing pediatric IBD.
Purpose of the Study:
- To evaluate the effect of infliximab (IFX) treatment on growth and bone health in children with IBD.
- To determine if IFX improves anthropometric measurements and bone markers in pediatric IBD patients.
Main Methods:
- Retrospective analysis of 33 pediatric IBD patients.
- Measurements included anthropometry, BMD, and bone markers one year before and after IFX initiation.
- Outcomes assessed were catch-up growth and indicators of bone health improvement.
Main Results:
- 64% of children showed positive catch-up growth after IFX treatment.
- IFX significantly increased 25-hydroxycholecalciferol (25-OHD) levels (p = 0.01) but did not influence BMD.
- Children with low BMD had higher inflammation and poorer nutritional status.
Conclusions:
- Infliximab treatment led to significant weight improvement and catch-up growth in pediatric IBD patients.
- Bone mass remained stable despite increased vitamin D, suggesting nutritional status is key for bone mineralization.
- Further research may explore combined strategies to optimize bone health in pediatric IBD during IFX therapy.
Aim:
Children with inflammatory bowel disease (IBD) have a high prevalence of growth retardation and low bone mineral density (BMD). This retrospective study investigated whether the start of infliximab treatment (IFX) was associated with improvement of growth and bone health.
Methods:
Anthropometry, BMD and bone markers were measured 1 year before and after the start of IFX treatment in 33 patients (51% males), with a median age of 13.5 years at baseline. Outcomes were growth with treatment and indicators of improved bone health.
Results:
Twenty-one children (64%) experienced a positive catch-up growth after IFX. Height standard deviation scores (SDS) were significantly higher in children in remission. Treatment with IFX was associated with a statistically significant increase in 25-hydroxycholecalciferol (25-OHD, p = 0.01). IFX had no influence on BMD. Children with low BMD < -2 had significantly higher inflammation scores, lower body mass index, weight, height SDS and 25-ODH after IFX.
Conclusion:
After treatment with IFX, children with IBD improved significantly in weight, with the majority achieving positive catch-up growth. Bone mass tended to remain static with time of treatment with IFX, despite a significant increase in 25-OHD. Improved nutritional status positively predicts improved bone mineralisation.
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