Growth and Weight Gain in Children with Juvenile Idiopathic Arthritis: results from the ReACCh-Out cohort.

Authors

Jaime Guzman, University of British Columbia
Tristan Kerr, British Columbia Children's Hospital
Leanne M Ward, University of Ottawa
Jinhui Ma, University of Ottawa
Kiem Oen, University of Manitoba
Alan M Rosenberg, University of Saskatchewan
Brian M Feldman, University of Toronto
Gilles Boire, Université de Sherbrooke
Kristin Houghton, University of British Columbia
Paul Dancey, Memorial University
Rosie Scuccimarri, McGill University
Alessandra Bruns, Université de Sherbrooke
Adam M Huber, Dalhousie University
Karen Watanabe Duffy, University of Ottawa
Natalie J Shiff, University of Florida
Roberta A Berard, Western University
Deborah M Levy, University of Toronto
Elizabeth Stringer, Dalhousie University
Kimberly Morishita, University of British Columbia
Nicole Johnson, University of Calgary
David A Cabral, University of British Columbia
Maggie Larché, McMaster University
Ross E Petty, University of British Columbia
Ronald M Laxer, University of Toronto
Earl Silverman, University of Toronto
Paivi Miettunen, University of Calgary
Anne-Laure Chetaille, Université Laval
Elie Haddad, Université de Montréal
Lynn Spiegel, University of Toronto
Stuart E Turvey, University of British Columbia
Heinrike Schmeling, University of Calgary
Bianca Lang, Dalhousie University
Janet Ellsworth, University of Alberta
Suzanne E Ramsey, Dalhousie University
Johannes Roth, University of Ottawa
Sarah Campillo, McGill University
Susanne Benseler, University of Calgary
Gaëlle Chédeville, McGill University
Rayfel Schneider, University of Toronto
Shirley M L Tse, University of Toronto
Roxana Bolaria, University of British Columbia
Katherine Gross, University of British Columbia
Debbie Feldman, Université de Montréal
Bonnie Cameron, University of Toronto
Roman Jurencak, University of Ottawa
Jean Dorval, Université Laval
Claire LeBlanc, McGill University
Claire St Cyr, Université de Montréal
Michele Gibbon, University of Ottawa
Rae S M Yeung, University of Toronto
Ciarán M Duffy, University of Ottawa
Lori B Tucker, University of British Columbia

Document Type

Article

Publication Date

8-22-2017

Journal

Pediatric Rheumatol Online Journal

Volume

15

Issue

1

URL with Digital Object Identifier

https://doi.org/10.1186/s12969-017-0196-7

Abstract

BACKGROUND: With modern treatments, the effect of juvenile idiopathic arthritis (JIA) on growth may be less than previously reported. Our objective was to describe height, weight and body mass index (BMI) development in a contemporary JIA inception cohort.

METHODS: Canadian children newly-diagnosed with JIA 2005-2010 had weight and height measurements every 6 months for 2 years, then yearly up to 5 years. These measurements were used to calculate mean age- and sex-standardized Z-scores, and estimate prevalence and cumulative incidence of growth impairments, and the impact of disease activity and corticosteroids on growth.

RESULTS: One thousand one hundred forty seven children were followed for median 35.5 months. Mean Z-scores, and the point prevalence of short stature (height < 2.5th percentile, 2.5% to 3.4%) and obesity (BMI > 95th percentile, 15.8% to 16.4%) remained unchanged in the whole cohort. Thirty-three children (2.9%) developed new-onset short stature, while 27 (2.4%) developed tall stature (>97.5th percentile). Children with systemic arthritis (n = 77) had an estimated 3-year cumulative incidence of 9.3% (95%CI: 4.3-19.7) for new-onset short stature and 34.4% (23-49.4) for obesity. Most children (81.7%) received no systemic corticosteroids, but 1 mg/Kg/day prednisone-equivalent maintained for 6 months corresponded to a drop of 0.64 height Z-scores (0.56-0.82) and an increase of 0.74 BMI Z-scores (0.56-0.92). An increase of 1 in the 10-cm physician global assessment of disease activity maintained for 6 months corresponded to a drop of 0.01 height Z-scores (0-0.02).

CONCLUSIONS: Most children in this modern JIA cohort grew and gained weight as children in the general population. About 1 in 10 children who had systemic arthritis, uncontrolled disease and/or prolonged corticosteroid use, had increased risk of growth impairment.

Notes

Under Creative Commons Attribution License