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  • Poster presentation
  • Open Access

Impact of biologics on growth in children with juvenile idiopathic arthritis

  • 1,
  • 2,
  • 2 and
  • 3
Pediatric Rheumatology20119 (Suppl 1) :P139

  • Published:


  • Growth Hormone
  • Juvenile Idiopathic Arthritis
  • Standard Deviation
  • Disease Onset
  • Biological Agent


Juvenile idiopathic arthritis (JIA) is sometimes associated with growth impairment due to inflammation and/or steroid treatment. Biologics allow a better control of inflammation and may therefore have a positive effect on growth.


To assess growth of JIA children on biologics.


JIA patients followed in one reference center, who were prebupescent at onset of biologic treatment, were included. We collected data about their growth and their disease (course, treatments, activity). Heights were expressed in standard deviations (SD) corrected with target height, at disease onset, at onset of biologics and at last follow-up.


100 patients were included. 29% were systemic. Mean age and height were 4.26 years (0.7; 13.7) and 0.31 SD (-2.47; 5.46) respectively at disease onset, 7.1 years (1.6; 15.7) and -0.24 SD (-3.63;2.90) at onset of biologics (p<0.05), 11 years (2.3;19.5) and -0.15 SD (-4.95;3.52) at last follow-up. 93 had received anti-TNFα, 35 anti-IL1, 12 anti-IL-6 and 9 CTLA4-Ig. 45% had an active disease. More than one biological agent was statistically linked with poor growth. At last follow-up, 10 children had a growth delay and 6 were treated with growth hormone.


Growth delay was observed before biologics were started. On biologic treatment, growth velocity normalized, however there was no correction of growth delay. The discrepancy with previous studies, which showed a growth restoration on anti-TNF, might be linked to a higher proportion of systemic and severe polyarticular JIA patients. In a subset of patients, growth hormone treatment has to be discussed even at the era of biologics.

Authors’ Affiliations

Unité de Spécialités Pédiatriques, CHU Clocheville, Tours, France
Endocrinologie Pédiatrique, Necker Enfants Malades, Paris, France
Unité d'Immunologie, d'Hématologie et de Rhumatologie Pédiatriques, Necker Enfants Malades, Paris, France


© Uettwiller et al; licensee BioMed Central Ltd. 2011

This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.