OP0178

TOCILIZUMAB-EFFECTS ON GROWTH IMPAIRMENT IN SYSTEMIC JUVENILE IDIOPATHIC ARTHRITIS

T. Miyamae ^1,*T. Nozawa ²M. KIkuchi ¹T. Kizawa ¹T. Imagawa ¹S. Yokota ¹

¹Pediatrics, Yokohama City University, ²Pediatrics, Department Of Pediatrics, Yokohama City University, Yokohama, Japan

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 (⊿SDS), correlation between⊿SDS 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). 

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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