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P549 Adalimumab improves growth velocity in children with Crohn’s disease naïve to anti-TNF treatment

J. Martín-de-Carpi*1, E. Llerena1, M. Navalón-Rubio2, G. Pujol Muncunill1, D. Gil-Ortega2, V. Varea1, C. Sierra-Salinas3, V.M. Navas-López3, 4

1Unit for the Comprehensive Care of Paediatric Inflammatory Bowel Disease, Department of Paediatric Gastroenterology, Hepatology and Nutrition, Barcelona, Spain, 2Pediatric Gastroenterology Unit. Hospital Virgen de la Arrixaca, Murcia, Spain, 3Pediatric Gastroenterology and Nutrition Unit. Hospital Materno Infantil, Málaga, Spain, 4IBIMA, Biomedical Institute of Málaga, Málaga, Spain

Background

Adalimumab (ADA), monoclonal humanised anti-TNF antibody is usually prescribed as a second-line therapy in paediatric Crohn´s disease (CD) patients who have lost response or developed intolerance to infliximab (IFX). Malnutrition and growth failure are detrimental consequences in children with CD. Up to 88% of patients with CD has growth retardation at diagnosis, and almost 50% during the follow-up. We reported the effects of ADA treatment on growth velocity in paediatric CD patients naïve to anti-TNF.

Methods

We conducted a multicentre retrospective study that included CD anti-TNF naïve paediatric patients treated with ADA as first-line anti-TNF. Weight and height were measured at baseline and after 52 weeks of treatment with ADA, with the patient barefoot and in underwear. Growth velocity, weight, height, and BMI z-scores were calculated using data from Spanish growth charts.

Results

In total, 40 children (22 females) with CD and naïve to anti-TNF treatment were included in the study. The mean age at diagnosis was 11.3 years (SD, 3.7) and median disease duration before initiating ADA treatment was 9.0 months (IQR, 4.0–22.0). wPCDAI, FC, CRP, ESR, and albumin improve after 52 weeks of treatment (Table 1). Mean height, growth velocity and BMI z-scores improved significantly between baseline and week 52 mainly in patients with growth failure (Table 2).

Table 1 Outcome of anthropometric, wPCDAI, and laboratory parameters after adalimumab treatment

Table 2 Median basal height velocity z-score and change from baseline at weeks 52

Conclusion

ADA significantly improved growth velocity in children with CD who had growth delay at baseline.