AB0987 STUDY ON THE FACTORS AFFECTING THE FINAL ADULT HEIGHT IN JUVENILE IDIOPATHIC ARTHRITIS
Authors: C. Hsin-Yu, H. Ya-Chiao, B. L. Chiang
Journal: Annals of the Rheumatic Diseases (2020)

Background: Juvenile idiopathic arthritis (JIA), a chronic inflammatory disease involving limited joints and/or constitutional symptoms in childhood or adolescent, might affect body height and result in short stature in adulthood. Well-controlled disease activity is beneficial in improving growth impairment in JIA patient. Objectives: To identify any factors that influence final adult height in the patient with juvenile idiopathic arthritis. Methods: We retrospectively reviewed the medical records of JIA patients between 2009 to 2019 in National Taiwan University Hospital. The diagnosis of JIA was according to the International League of Associations for Rheumatology (ILAR) criteria. Personal history, laboratory reports, and medication were analyzed. The difference between final adult height and target height was calculated in each patient. We defined whose final adult height higher than target height as positive group and the others as negative group. A cox univariate proportional hazards model was applied to compare the variables between these two groups. Results: Total 120 patients are collected. There are 74 (61.7%) and 46 (38.3%) cases in the positive and the negative group, respectively. The mean onset age of disease is 11.78 3.78 in positive group and 10.83 4.04 in negative group. Male is more than female in both groups, with a ratio of 1.7:1 and 2.7:1 respectively. Enthesis-related arthritis accounted for the most in positive group, however, in negative group, oligo-arthritis was the most common type. There are slightly more patients having received biologics in positive group than negative group without significance (64.8% vs. 54.3%, p =0.33). Among the patients treated with etanercept, those in the negative group had a significantly younger age when they started the treatment compare to the positive group (11.8 3.1 vs. 13.9 3.1, P =0.01). The patients in positive group had significantly higher final adult height (171.08.7 vs. 162.9 8.1, P &lt; 0.001). The univariate analysis showed that the age when etanercept treatment started was associated with the occurrence of a negative difference between final height and target height (odds ratio=0.80, 95%CI=0.67-0.96, P =0.02). Conclusion: In JIA patients, 38.3% of them had a negative difference between final adult height and target height. The subtype might play a critical role in affecting the growth of patients. A younger age when the child received etanercept was associated with a lower attained adult height than target height, however, it needs further analysis on the medication of these children. References: [1]S.-J. Wang et al., Attained Adult Height in Juvenile Rheumatoid Arthritis with or without Corticosteroid Treatment, Clin Rheumatol (2002) 21:363–368 [2]P Tynja¨la et al., Impact of anti-TNF treatment on growth in severe juvenile idiopathic arthritis, Ann Rheum Dis 2006;65:1044–1049 [3]Edward H. Giannini et al., Effects of Long-Term Etanercept Treatment on Growth in Children With Selected Categories of Juvenile Idiopathic Arthritis, ARTHRITIS &amp; RHEUMATISM Vol. 62, No. 11, November 2010, pp 3259–3264 [4]Ashley Shafferman et al, Changes in Body Mass Index in Children with Juvenile Idiopathic Arthritis Treated with Tumor Necrosis Factor Inhibitors, J Rheumatol 2014;41;113-118 [5]Lianne Kearsley-Fleet et al., Growth in children and adolescents with juvenile idiopathic arthritis over 2 years of treatment with etanercept: results from the British Society for Paediatric and Adolescent Rheumatology Etanercept Cohort Study, Rheumatology 2015;54:1279-1285 [6]Florence Uettwiller et al., Effect of Biologic Treatments on Growth in Children with Juvenile Idiopathic Arthritis, J Rheumatol 2014;41;128-135 [7]Lianne Kearsley-Fleet et al., Short-term outcomes in patients with systemic juvenile idiopathic arthritis treated with either tocilizumab or anakinra, Rheumatology 2019;58:94-102 Disclosure of Interests: None declared