Improvement in Growth of Children With Crohn Disease Following Anti‐TNF‐α Therapy Can Be Independent of Pubertal Progress and Glucocorticoid Reduction

Abstract

Clinical response to infliximab therapy is associated with an improvement in linear growth in the short term in children with CD. This increase in height may not be simply due to progress in pubertal status or reduction in GC dose.

Clinical progress in the two years following a course of exclusive enteral nutrition in 109 paediatric patients with Crohn's disease

“…Previous work examining height outcomes have shown short term improvement in height velocity in patients treated with infliximab. 30,31 However, when Pfefferkorn et al considered the longer term effects on growth velocity with a 2 year follow-up of a large cohort of children from North America no sustained effect was seen for infliximab. 13 Furthermore, no significant improvement was seen in height z-score at 2 year follow-up with any form of treatment.…”

Growth retardation in pediatric inflammatory bowel diseases – pathogenesis and treatment

“…This process was accompanied by a statistically significant increase in specific bone alkaline phosphatase as a marker of increased osteoblastic activity. In patients who did not respond to the treatment an improvement of growth velocity was not observed [20]. Borrelli et al also demonstrated that the effect of that treatment was significantly better if the treatment was prolonged than if it was limited to induction with three doses of the drug [21].…”

Impact of Therapeutic Strategies on Growth in Pediatric Inflammatory Bowel Disease

“…Anti-TNF agents have a promising potential for improving growth as they were shown to induce prompt mucosal healing [110,111], reverse the pro-inflammatory cytokines cascade [113] and enable prolonged corticosteroid withdrawal [108][109][110]. Indeed, numerous studies suggest an increase in height velocity and height z-score following prolonged anti-TNF treatment, providing treatment is undertaken early enough prior to or during puberty [4,106,111,112,[114][115][116][117][118][119][120]. In contrast, Sinitsky et al [121] reported a significant improvement in BMI z-score at one year of treatment with IFX in children with CD but failed to show significant changes in height velocity.…”