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Changes in body mass index in children with juvenile idiopathic arthritis treated with tumor necrosis factor
Ashley Shafferman1, Kevin R Fontaine, Randy Q Cron
1From the Department of Health Behavior, and the Division of Pediatric Rheumatology, University of Alabama School of Medicine, and the University of Alabama School of Public Health, Birmingham, Alabama, USA.
Insights
Tumor necrosis factor (TNF) inhibitor therapy did not significantly alter body mass index (BMI) in children with juvenile idiopathic arthritis (JIA) over two years compared to those not receiving treatment.
Area of Science:
- Pediatric Rheumatology
- Clinical Immunology
- Biostatistics
Background:
- Juvenile idiopathic arthritis (JIA) is a chronic autoimmune condition affecting children.
- Body mass index (BMI) changes are a concern in chronic inflammatory diseases and their treatments.
- Tumor necrosis factor (TNF) inhibitors are a common therapy for JIA.
Purpose of the Study:
- To compare changes in BMI z-scores and categories in JIA patients treated with TNF inhibitors versus those not receiving this therapy.
- To assess the long-term impact of TNF inhibitor use on weight status in pediatric JIA patients.
Main Methods:
- Retrospective chart review of children with JIA.
- Comparison of a cohort initiating TNF inhibitor therapy (TNF cohort) with a control cohort not receiving TNF inhibitors (comparator cohort).
- Analysis of age and sex-specific BMI z-scores and categories over at least one year of follow-up.
Main Results:
- The TNF cohort (n=167) showed a statistically significant increase in BMI z-score (+0.15, p=0.02), but this was not significantly different from the comparator cohort (n=37, +0.09, p=0.5).
- No significant changes in the proportions of overweight or obese children were observed in the TNF cohort compared to baseline or the comparator cohort.
- Median follow-up was 2.8 years for the TNF cohort and 2.2 years for the comparator cohort.
Conclusions:
- Over two years, TNF inhibitor therapy in children with JIA did not lead to a significant increase in BMI compared to controls.
- This suggests TNF inhibitors may not adversely affect BMI in pediatric JIA patients over this follow-up period.
Objective:
To evaluate changes in body mass index (BMI) among cohorts of children with juvenile idiopathic arthritis (JIA) with and without tumor necrosis factor (TNF) inhibitor therapy.
Methods:
We performed a retrospective chart review of children with JIA who newly initiated TNF inhibitor therapy and had at least 1 year of subsequent followup (TNF cohort). We also included children with JIA and at least 1 year of followup without any TNF inhibitor therapy (comparator cohort). Children with systemic arthritis were excluded. Age and sex specific BMI z-scores and their corresponding categories (normal, overweight, obese) were determined. We compared changes from a baseline visit to the last followup visit using t-test for BMI z-scores and chi square and Kruskal-Wallis tests for BMI categories.
Results:
The TNF cohort had 167 patients; the comparator cohort had 37. The median study followup was 2.8 and 2.2 years, respectively. The cohorts had similar age, sex, race, weight, and height distributions. The TNF cohort had a statistically significant increase in BMI z-score from baseline (+0.15; p = 0.02) that was not significantly different from the increase (+0.09) observed in the comparator cohort (p = 0.5). There was no significant change in the proportions of overweight and obese children in the TNF cohort compared to baseline (p = 0.6) or compared to the change in the comparator cohort (p = 0.2).
Conclusion:
Over more than 2 years of followup, we did not observe a significant increase in BMI among children with JIA receiving TNF inhibitor compared to those not receiving it.
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