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02-11-2017 | Rheumatology | News | Article

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Early treatment of growth failure important in severe juvenile idiopathic arthritis

medwireNews: Research shows that age at initiation of growth hormone (GH) therapy is a key determinant of whether children with juvenile idiopathic arthritis (JIA) will achieve a favorable growth outcome.

After accounting for confounders, older age at GH initiation and more severe inflammation during follow-up (reflected in C-reactive protein levels) were associated with a significantly reduced likelihood of a favorable growth outcome, defined as an adult height standard deviation score of –1.5 or better.

Dominique Simon (Hôpital Robert Debré, Paris, France) and study co-authors therefore stress that “clinical monitoring of growth remains crucial,” because the “loss of height observed during JIA, unpredictable severity of the disease, and limiting effects of chronic inflammation on the growth response to GH support the initiation of GH therapy before the growth deficiency becomes severe.”

As reported in The Journal of Clinical Endocrinology & Metabolism, the team assessed data from 48 patients, identified in three studies, who started GH therapy at a median age of 10 years. Patients’ final adult height, after a median 6.5 years of treatment, was a median of 9 cm below their target height (based on parental heights), although 52% achieved a height within the normal range.

By Eleanor McDermid

medwireNews is an independent medical news service provided by Springer Healthcare. © 2017 Springer Healthcare part of the Springer Nature group

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