Makhlouf Yasmine, Ayed Hiba Ben, Miladi Saoussen, Boussaa Hiba, Abdelghani Kawther Ben, Fazaa Alia, Laatar Ahmed
Department of rheumatology, Mongi Slim Hospital, La marsa, Tunis, Tunisia.
University Tunis El Manar, Tunis, Tunisia.
PLoS One. 2025 May 28;20(5):e0324440. doi: 10.1371/journal.pone.0324440. eCollection 2025.
Children with Juvenile idiopathic arthritis (JIA) often experience growth retardation due to various factors. The advent of biologic therapies has revolutionized the management of aggressive forms of JIA. This systematic review aims to provide updated insights into the impact of biologic treatments on growth retardation in pediatric JIA patients. Following PRISMA guidelines, we systematically searched Medline, Embase, and the Cochrane Library for eligible articles. Included were cohort studies, trials, and retrospective studies that evaluated growth outcomes in children with JIA receiving biologic therapy. Twelve studies published between 2003 and 2018 were analyzed, encompassing 1513 patients with a mean age of 11.4 years. Tumor necrosis factor alpha inhibitors were the predominant biologic agents used (75.8%), with a mean follow-up duration of 2 years post-biologic therapy initiation. Growth assessment criteria included Height Standard-deviation-score (HSDS), growth velocity, and height velocity (cm/year). Before biologic treatment, 15% of patients exhibited growth delay, while 75.4% had impaired growth. Following biologic therapy, growth delay decreased to 8% and impaired growth to 36.8%. Patients with systemic JIA showed lower changes in growth parameters compared to others, and no significant differences were observed between different biologic drugs. However, lower growth velocity changes were noted in patients treated with multiple biologic agents. Two studies suggested that growth catch-up was most pronounced during the first year of treatment. This systematic review highlights the potential of biologic therapies in mitigating growth impairment associated with JIA. Despite observed positive effects, further research is warranted to elucidate underlying mechanisms and optimize treatment strategies.
幼年特发性关节炎（JIA）患儿常因多种因素出现生长发育迟缓。生物疗法的出现彻底改变了侵袭性JIA的治疗方式。本系统评价旨在提供关于生物治疗对儿童JIA患者生长发育迟缓影响的最新见解。遵循PRISMA指南，我们系统检索了Medline、Embase和Cochrane图书馆以查找符合条件的文章。纳入的研究包括队列研究、试验和回顾性研究，这些研究评估了接受生物治疗的JIA患儿的生长结局。分析了2003年至2018年间发表的12项研究，涉及1513例患者，平均年龄为11.4岁。肿瘤坏死因子α抑制剂是使用的主要生物制剂（75.8%），生物治疗开始后的平均随访时间为2年。生长评估标准包括身高标准差评分（HSDS）、生长速度和身高增长速度（厘米/年）。在生物治疗前，15%的患者出现生长延迟，而75.4%的患者生长受损。生物治疗后，生长延迟降至8%，生长受损降至36.8%。与其他患者相比，全身型JIA患者的生长参数变化较小，不同生物药物之间未观察到显著差异。然而，接受多种生物制剂治疗的患者生长速度变化较小。两项研究表明，生长追赶在治疗的第一年最为明显。本系统评价强调了生物疗法在减轻与JIA相关的生长损害方面的潜力。尽管观察到了积极效果，但仍有必要进一步研究以阐明潜在机制并优化治疗策略。
