Early Infliximab Yields Superior Long-Term Effects on Linear Growth in Pediatric Crohn's Disease Patients

Gut Liver. 2018 May 15;12(3):255-262. doi: 10.5009/gnl17290.

Abstract

Background/aims: Information regarding the efficacy of early infliximab treatment in pediatric patients with Crohn's disease (CD) is limited. We aimed to evaluate the impact of early combined immunosuppression on linear growth in pediatric patients with CD by performing step-up comparisons.

Methods: This retrospective study included pediatric patients with moderate-to-severe CD, who received a combination therapy with infliximab and azathioprine for at least 3 years and sustained corticosteroid-free remission without loss of response. The z-scores of the growth indicators obtained at the time of diagnosis and annually for 3 years thereafter were compared between the two groups.

Results: The early combined immunosuppression group displayed significantly increased linear growth 3 years after diagnosis (p=0.026). A significant difference was also observed in the linear growth 3 years after diagnosis between subgroups of Tanner stages 1-2 (p=0.016).

Conclusions: The early introduction of biologics should be considered to improve linear growth in pediatric patients with CD.

Keywords: Growth; Height; Infliximab; Tanner stage.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Azathioprine / therapeutic use*
  • Child
  • Crohn Disease / drug therapy*
  • Drug Therapy, Combination
  • Female
  • Gastrointestinal Agents / therapeutic use*
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Infliximab / therapeutic use*
  • Male
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Gastrointestinal Agents
  • Immunosuppressive Agents
  • Infliximab
  • Azathioprine

Supplementary concepts

  • Pediatric Crohn's disease