Tocilizumab-effects on growth impairment in systemic juvenile idiopathic arthritis

Abstract

Background The safety and efficasy of anti-IL-6 receptor monoclonal antibody, tocilizumab (TCZ) has been reported in children with systemic juvenile idiopathic arthritis (s-JIA). Objectives Growth analysis during the study was performed. Methods Forty-five s-JIA patients (8.1±4.2 years) who completed phase-III study of TCZ were enrolled. Mean standard deviation score (SDS) for height, changes in SDS from baseline (ΔSDS), correlation between ΔSDS and several factors such as age, disease duration, corticosteroid dose exposure were evaluated. Yearly height velocity analysis was made with 28 patients who had data for 1 year prior to TCZ administration and received TCZ for more than 1 year. Results Thirty-eight of 45 (84%) obtained clinical response at week 144. The baseline SDS-height was -2.7±2.0 with inverse correlation with disease duration. Significant improvement was seen in height velocity SDS changes from 1 year prior to 1 year posterior to baseline (n=28, -6.0±4.0 to-2.5±3.9, p =0.0064). Reduction in corticosteroid exposure was significantly associated with improvement in height velocity SDS ( p =0.0027). Standardized height velocity continued to improve over 3 years of TCZ, whereas average daily prednisolone equivalent dose showed inverse correlation (n=17, Figure). Conclusions Growth impairments evidenced by SDS-height were more prominent in patients with longer standing disease. Catch up growth was observed in patients who required less or no corticosteroid during TCZ treatment. References Yokota S, et al. Lancet. 2008 Mar 22;371(9617):998-1006. Disclosure of Interest None Declared