- Poster presentation
- Open access
- Published:
Effects of antirheumatic treatment with tocilizumab on longitudinal growth in children with juvenile idiopathic arthritis
Pediatric Rheumatology volume 12, Article number: P62 (2014)
Introduction
Inflammation and glucocorticoid therapy are major factors in the growth retardation seen in children with severe forms of juvenile idiopathic arthritis (JIA).
Objectives
The objective of the this study was to evaluate effects of antirheumatic treatment with recombinant humanised monoclonal antibody that acts as IL-6R antagonist (tocilizumab ) on longitudinal growth.
Methods
Nineteen patients with systemic JIA was included into the study (8 boys and 11 girls). The mean age at first visit was 6.8 ± 2.4 years, and disease duration 4 (2,2;6) years. All patients had stage 1 of sexual development by Tanner scale and before therapy with tocilizumab had standard antirheumatic therapy. Anthropometric parameters were estimated one year before tocilizumab treatment, at the day of first infusion and in one year after tocilizumab treatment was started. SDS for height and height velocity calculated against the growth curves for European population (Auxology, Pfizer, Version 1.0).
Tocilizumab was administered intravenously once every 2 weeks at a dose of 8-12 mg/kg of body weight. In all patients who received corticosteroids before tocilizumab treatment dose of prednisolone was reduced from 0.5 (0.4; 0.6) to 0.1 (0.02; 0.2), but not in one case it was completely abolished. Treatment efficacy was assessed according to criteria ACR pedi scale.
Results
Clinical response to the treatment was obtained in all patients included in this study. The ACR Pedi 50, 70 and 90 improvement were achieved by 3, 3, and 1 patients at Week 52, Inactive disease was achieved by 11 patients at week 52. The mean height SDS one year before treatment was -2.38 ±1.43 and -2.64±1.94 by the day of 1st tocilizumab infusion (p < 0.001). Height velocity SDS was -4.24 ±1.18 and -4.55 ±1.49 respectively (p < 0.001). After one year of treatment the mean height SDS was -2.27 ±1.85 and height velocity SDS 2.51 ±1.98 (p < 0.001).
Conclusion
An intensified antirheumatic treatment with tocilizumab has a beneficial effect on growth in children with JIA. This effect might be related to the inhibitory effect of proinflammatory cytokines, especially Il-6, on the synthesis of IGF-1 and IGF-BP-3.
Disclosure of interest
None declared.
Author information
Authors and Affiliations
Rights and permissions
Open Access  This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made.
The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.
To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/.
The Creative Commons Public Domain Dedication waiver (https://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
About this article
Cite this article
Alexeeva, E., Denisova, R., Valieva, S. et al. Effects of antirheumatic treatment with tocilizumab on longitudinal growth in children with juvenile idiopathic arthritis. Pediatr Rheumatol 12 (Suppl 1), P62 (2014). https://doi.org/10.1186/1546-0096-12-S1-P62
Published:
DOI: https://doi.org/10.1186/1546-0096-12-S1-P62