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Growth failure is rare in a contemporary cohort of paediatric inflammatory bowel disease patients

Growth failure is rare in a contemporary cohort of paediatric inflammatory bowel disease patients
Growth failure is rare in a contemporary cohort of paediatric inflammatory bowel disease patients

Aim: We assessed growth in a paediatric inflammatory bowel disease (PIBD) cohort. Methods: Paediatric inflammatory bowel disease patients were eligible if they were diagnosed at Southampton Children's Hospital from 2011 to 2018. Weight and height standard deviation scores (SDS) were retrieved. Mean SDS values, SDS change and anti-TNF status were analysed at diagnosis and during follow-up. Results: Four hundred and ninety patients were included, 313 with Crohn's disease (CD). CD patients presented with mean height SDS −0.13, −0.1 at 1-year, −0.11 at 2-years and −0.03 at 5 years, reflecting preserved linear growth. There was no significant height-SDS change from diagnosis to 5-year follow-up, +0.12, 95%-CI: 0.48 to −0.24. Mean weight-SDS at diagnosis was −0.39, driven by CD patients (−0.65). Mean weight-SDS approached 0 after 1 year and remained at the 50th centile throughout follow-up. Growth in ulcerative colitis was maintained. In multivariable regression males had worse height growth from diagnosis to transition (P =.036). Anti-TNF treatment (P =.013) and surgical resection (P =.005) were also associated with poorer linear growth. Patients treated with anti-TNF therapy had lower height-SDS compared to those never treated with anti-TNF at 1 year (−0.2 vs −0.01, P =.22), 2-years (−0.27 vs −0.01, P =.07) and 5 years (−0.21 vs 0.25, P =.051). Conclusion: Height was generally maintained in Crohn's disease, and impaired linear growth was rare in this cohort.

Crohn's disease, anti-TNF, growth, height, inflammatory bowel disease, paediatric, weight
0803-5253
326-334
Ashton, James
03369017-99b5-40ae-9a43-14c98516f37d
Green, Zachary
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Young, Aneurin
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Borca, Florina
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Coelho, Tracy
a78b627c-ea78-41e1-9553-0390921e3c93
Batra, Akshay
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Afzal, Nadeem A.
62505946-2503-42ba-9b02-85513bb3ec87
Ennis, Sarah
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Johnson, Mark J.
63704974-cd2b-4f11-addd-db259fb8f0e0
Beattie, Robert
9a66af0b-f81c-485c-b01d-519403f0038a
Ashton, James
03369017-99b5-40ae-9a43-14c98516f37d
Green, Zachary
927f42a3-e038-493c-b0af-cab62a7f5560
Young, Aneurin
cf3d7c90-4f55-4467-a59c-a84b5e5915ed
Borca, Florina
31fc3965-6bcf-4fd6-85bc-8b0f99f62473
Coelho, Tracy
a78b627c-ea78-41e1-9553-0390921e3c93
Batra, Akshay
822f891e-87ca-41d9-b68d-27c395e88809
Afzal, Nadeem A.
62505946-2503-42ba-9b02-85513bb3ec87
Ennis, Sarah
7b57f188-9d91-4beb-b217-09856146f1e9
Johnson, Mark J.
63704974-cd2b-4f11-addd-db259fb8f0e0
Beattie, Robert
9a66af0b-f81c-485c-b01d-519403f0038a

Ashton, James, Green, Zachary, Young, Aneurin, Borca, Florina, Coelho, Tracy, Batra, Akshay, Afzal, Nadeem A., Ennis, Sarah, Johnson, Mark J. and Beattie, Robert (2021) Growth failure is rare in a contemporary cohort of paediatric inflammatory bowel disease patients. Acta Paediatrica, 110 (1), 326-334. (doi:10.1111/apa.15383).

Record type: Article

Abstract

Aim: We assessed growth in a paediatric inflammatory bowel disease (PIBD) cohort. Methods: Paediatric inflammatory bowel disease patients were eligible if they were diagnosed at Southampton Children's Hospital from 2011 to 2018. Weight and height standard deviation scores (SDS) were retrieved. Mean SDS values, SDS change and anti-TNF status were analysed at diagnosis and during follow-up. Results: Four hundred and ninety patients were included, 313 with Crohn's disease (CD). CD patients presented with mean height SDS −0.13, −0.1 at 1-year, −0.11 at 2-years and −0.03 at 5 years, reflecting preserved linear growth. There was no significant height-SDS change from diagnosis to 5-year follow-up, +0.12, 95%-CI: 0.48 to −0.24. Mean weight-SDS at diagnosis was −0.39, driven by CD patients (−0.65). Mean weight-SDS approached 0 after 1 year and remained at the 50th centile throughout follow-up. Growth in ulcerative colitis was maintained. In multivariable regression males had worse height growth from diagnosis to transition (P =.036). Anti-TNF treatment (P =.013) and surgical resection (P =.005) were also associated with poorer linear growth. Patients treated with anti-TNF therapy had lower height-SDS compared to those never treated with anti-TNF at 1 year (−0.2 vs −0.01, P =.22), 2-years (−0.27 vs −0.01, P =.07) and 5 years (−0.21 vs 0.25, P =.051). Conclusion: Height was generally maintained in Crohn's disease, and impaired linear growth was rare in this cohort.

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Untracked_Growth failure is rare_15_05_20 - Accepted Manuscript
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Accepted/In Press date: 27 May 2020
e-pub ahead of print date: 2 June 2020
Published date: January 2021
Additional Information: Funding Information: JJA is funded by an Action Medical Research, Research Training fellowship and an ESPEN fellowship. This study is supported by the National Institute for Health Research through the NIHR Southampton Biomedical Research Centre. MJJ and RMB are supported by the National Institute for Health Research through the NIHR Southampton Biomedical Research Centre. Publisher Copyright: © 2020 Foundation Acta Pædiatrica. Published by John Wiley & Sons Ltd
Keywords: Crohn's disease, anti-TNF, growth, height, inflammatory bowel disease, paediatric, weight

Identifiers

Local EPrints ID: 441238
URI: http://eprints.soton.ac.uk/id/eprint/441238
ISSN: 0803-5253
PURE UUID: 886dd56f-2055-4686-82bf-7841217a5515
ORCID for James Ashton: ORCID iD orcid.org/0000-0003-0348-8198
ORCID for Aneurin Young: ORCID iD orcid.org/0000-0003-3549-3813
ORCID for Sarah Ennis: ORCID iD orcid.org/0000-0003-2648-0869

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Date deposited: 05 Jun 2020 16:31
Last modified: 19 Oct 2022 04:03

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Contributors

Author: James Ashton ORCID iD
Author: Zachary Green
Author: Aneurin Young ORCID iD
Author: Florina Borca
Author: Tracy Coelho
Author: Akshay Batra
Author: Nadeem A. Afzal
Author: Sarah Ennis ORCID iD
Author: Mark J. Johnson
Author: Robert Beattie

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