Growth in children receiving contemporary disease specific therapy for Crohn's disease

Malik, S., Mason, A., Bakhshi, A., Young, D., Bishop, J., Garrick, V., McGrogan, P., Russell, R. K. and Ahmed, S. F. (2012) Growth in children receiving contemporary disease specific therapy for Crohn's disease. Archives of Disease in Childhood, 97(8), pp. 698-703. (doi: 10.1136/archdischild-2011-300771) (PMID:22685044)

Abstract

Introduction: It is unclear whether recent therapeutic advances have improved the growth of children with Crohn's disease (CD).<p></p> Aim: To assess the frequency of short stature and poor growth and their relationship to disease course and therapy in children with CD.<p></p> Methods: The anthropometric and treatment details of 116 children (68 male) with a mean (range) age at diagnosis of 10.8 years (4.9–15.5) and a mean age at maximum follow-up (MF) of 15.4 years (9.4–19.3) were studied retrospectively at diagnosis (T0), at 1 (T1), 2 (T2) and 3 years (T3) after diagnosis and at MF.<p></p> Results: At T0, mean height SD score (HtSDS) was −0.5 (−3.3 to 2.6) compared to a mid-parental HtSDS of 0.2 (−2.0 to 01.4) (p=0.002). At T1, T2, T3 and MF, mean HtSDS was −0.6 (−4.8 to 7.8), −0.6 (−2.9 to 2.2), −0.7 (−3.6 to 2.5) and −0.5 (−3.5 to 2.9), respectively. Mean Ht velocity (HV) SDS at T1, T2, T3 and MF was −1.4 (−7.4 to 7.4), −0.6 (−7.5 to 6.1), −0.1 (−6.6 to 7.6) and 0.6 (−4.8 to 7.8), respectively (p<0.05). In final models, HtSDS was associated negatively with the use of prednisolone (p=0.0001), azathioprine (p=0.0001), methotrexate (p=0.0001) and weight SDS (WtSDS) (p=0.0001). HVSDS was associated positively with age (p=0.0001) and WtSDS (p=0.01). ΔHtSDS was associated negatively with use of prednisolone (p<0.02).<p></p> Conclusion: Although current therapy for CD is associated with improved rate of growth for the first few years, a substantial proportion of children remain short. This study also highlights the need for consistency in describing growth in children with chronic diseases.<p></p>

• Item Type: Articles
• Additional Information: SM is funded by the University of Balochistan Higher Education Commission of Pakistan. RKR is supported by an NHS Research Scotland career fellowship award and received support from a Medical Research Council (MRC) patient research cohorts initiative grant (G0800675) for PICTS. The IBD team at Yorkhill, Glasgow is supported by the Catherine McEwan Foundation and the Yorkhill IBD fund.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Russell, Dr Richard and Mason, Dr Avril and McGrogan, Dr Paraic and Ahmed, Professor Syed Faisal and Bakhshi, Mrs Andisheh
• Authors: Malik, S., Mason, A., Bakhshi, A., Young, D., Bishop, J., Garrick, V., McGrogan, P., Russell, R. K., and Ahmed, S. F.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre; College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Archives of Disease in Childhood
• Journal Abbr.: Arch Dis Child
• Publisher: BMJ Publishing Group
• ISSN: 0003-9888
• ISSN (Online): 1468-2044
• Published Online: 09 June 2012
• Published Online: 09 June 2012