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Growth and Weight Gain in Children with Juvenile Idiopathic Arthritis: results from the ReACCh-Out cohort.
Pediatric Rheumatol Online Journal
  • Jaime Guzman, University of British Columbia
  • Tristan Kerr, British Columbia Children's Hospital
  • Leanne M Ward, University of Ottawa
  • Jinhui Ma, University of Ottawa
  • Kiem Oen, University of Manitoba
  • Alan M Rosenberg, University of Saskatchewan
  • Brian M Feldman, University of Toronto
  • Gilles Boire, Université de Sherbrooke
  • Kristin Houghton, University of British Columbia
  • Paul Dancey, Memorial University
  • Rosie Scuccimarri, McGill University
  • Alessandra Bruns, Université de Sherbrooke
  • Adam M Huber, Dalhousie University
  • Karen Watanabe Duffy, University of Ottawa
  • Natalie J Shiff, University of Florida
  • Roberta A Berard, Western University
  • Deborah M Levy, University of Toronto
  • Elizabeth Stringer, Dalhousie University
  • Kimberly Morishita, University of British Columbia
  • Nicole Johnson, University of Calgary
  • David A Cabral, University of British Columbia
  • Maggie Larché, McMaster University
  • Ross E Petty, University of British Columbia
  • Ronald M Laxer, University of Toronto
  • Earl Silverman, University of Toronto
  • Paivi Miettunen, University of Calgary
  • Anne-Laure Chetaille, Université Laval
  • Elie Haddad, Université de Montréal
  • Lynn Spiegel, University of Toronto
  • Stuart E Turvey, University of British Columbia
  • Heinrike Schmeling, University of Calgary
  • Bianca Lang, Dalhousie University
  • Janet Ellsworth, University of Alberta
  • Suzanne E Ramsey, Dalhousie University
  • Johannes Roth, University of Ottawa
  • Sarah Campillo, McGill University
  • Susanne Benseler, University of Calgary
  • Gaëlle Chédeville, McGill University
  • Rayfel Schneider, University of Toronto
  • Shirley M L Tse, University of Toronto
  • Roxana Bolaria, University of British Columbia
  • Katherine Gross, University of British Columbia
  • Debbie Feldman, Université de Montréal
  • Bonnie Cameron, University of Toronto
  • Roman Jurencak, University of Ottawa
  • Jean Dorval, Université Laval
  • Claire LeBlanc, McGill University
  • Claire St Cyr, Université de Montréal
  • Michele Gibbon, University of Ottawa
  • Rae S M Yeung, University of Toronto
  • Ciarán M Duffy, University of Ottawa
  • Lori B Tucker, University of British Columbia
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BACKGROUND: With modern treatments, the effect of juvenile idiopathic arthritis (JIA) on growth may be less than previously reported. Our objective was to describe height, weight and body mass index (BMI) development in a contemporary JIA inception cohort.

METHODS: Canadian children newly-diagnosed with JIA 2005-2010 had weight and height measurements every 6 months for 2 years, then yearly up to 5 years. These measurements were used to calculate mean age- and sex-standardized Z-scores, and estimate prevalence and cumulative incidence of growth impairments, and the impact of disease activity and corticosteroids on growth.

RESULTS: One thousand one hundred forty seven children were followed for median 35.5 months. Mean Z-scores, and the point prevalence of short stature (height < 2.5th percentile, 2.5% to 3.4%) and obesity (BMI > 95th percentile, 15.8% to 16.4%) remained unchanged in the whole cohort. Thirty-three children (2.9%) developed new-onset short stature, while 27 (2.4%) developed tall stature (>97.5th percentile). Children with systemic arthritis (n = 77) had an estimated 3-year cumulative incidence of 9.3% (95%CI: 4.3-19.7) for new-onset short stature and 34.4% (23-49.4) for obesity. Most children (81.7%) received no systemic corticosteroids, but 1 mg/Kg/day prednisone-equivalent maintained for 6 months corresponded to a drop of 0.64 height Z-scores (0.56-0.82) and an increase of 0.74 BMI Z-scores (0.56-0.92). An increase of 1 in the 10-cm physician global assessment of disease activity maintained for 6 months corresponded to a drop of 0.01 height Z-scores (0-0.02).

CONCLUSIONS: Most children in this modern JIA cohort grew and gained weight as children in the general population. About 1 in 10 children who had systemic arthritis, uncontrolled disease and/or prolonged corticosteroid use, had increased risk of growth impairment.


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Citation Information
Jaime Guzman, Tristan Kerr, Leanne M Ward, Jinhui Ma, et al.. "Growth and Weight Gain in Children with Juvenile Idiopathic Arthritis: results from the ReACCh-Out cohort." Pediatric Rheumatol Online Journal Vol. 15 Iss. 1 (2017)
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