A French group of researchers reports that anti-tumor necrosis factor alpha (anti-TNFa) therapy has the ability to prevent loss of height in some Crohn’s disease patients, and starting treatment early may improve growth in these patients.
In childhood-onset Crohn’s disease it’s common to see growth failure both at diagnosis an at follow-up. This is mainly due to chronic inflammation, malnutrition, and prolonged corticosteroid therapy. Several treatments currently used in the clinic aim not only to achieve disease remission but also to allow normal growth and development at puberty.
Anti-TNFα therapy is an efficient treatment in Crohn’s patients, with some researchers reporting that 90 percent of patients achieve a short-term remission and up to 60 percent experience long-term sustained clinical benefits. Overall anti-TNFα antibodies can lead to short-term improvements in height velocity (HV) and height standard deviation score (H-SDS). The effects of this therapy in adult height are not fully understood, however.
In the paper, titled “Growth and Adult Height in Patients with Crohn’s Disease Treated with Anti-Tumor Necrosis Factor α Antibodies,” published in the journal Plos One, researchers sought to understand the mid-term effects on growth in children with Crohn’s disease undergoing maintenance Remicade (infliximab) or Humira (adalimumab), both anti-TNFα therapies. In some cases, the children were followed until they completed their growth and their adult height was also evaluated.
A total 61 Crohn’s patients participated in the study. Researchers measured their height and estimated their expected adult height. This was determined by taking into account their body mass index and their parent’s height.
It was observed that the anti-TNFα therapy stopped the loss of height detected after diagnosis. Overall, 62 percent of the patients in the study were able to reach their adult height. Their adult H-SDS was reported to be within the normal range, but it was still significantly lower than their expected height. This indicates that anti-TNFα treatment was unable to fully restore the patient’s genetic growth potential.
The study indicates that anti-TNFα therapy can help early-onset Crohn’s patients achieve a significant normal growth. But due to the small number of patients included in this study who reached their adult height, the authors wrote that it is still hard to make definite conclusions about the effects of biotherapy on adult height, and additional studies are required.