What exactly are biologic therapies and how do they work?

Biologic therapies are a class of medications that target specific components of the immune system, such as tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6). Unlike traditional treatments that broadly suppress the immune system, biologics selectively block these molecules that drive inflammation. This targeted approach aims to reduce inflammation with potentially fewer widespread side effects, making it particularly valuable for children with chronic inflammatory conditions.

What is growth velocity, and why is it so important for children with chronic inflammatory diseases?

Growth velocity is the rate at which a child grows over time. In children with chronic inflammatory diseases, inflammation and treatments like glucocorticoids can inhibit growth velocity, leading to stunted growth. Restoring growth velocity is important because it allows children to reach their full height potential and supports overall healthy development. Biologic therapies are significant as they aim to restore a normal growth rate by reducing inflammation and minimizing the use of steroids.

What are glucocorticoids and why is reducing reliance on them important in treating children with chronic inflammatory diseases?

Glucocorticoids, also known as steroids, are medications used to reduce inflammation. While effective in managing inflammation, they can have significant side effects, including growth suppression in children. The reliance on glucocorticoids creates a difficult balancing act, as controlling the disease is essential, but minimizing the harm to a child's growth is equally important. Biologic therapies play a role in reducing or eliminating the need for glucocorticoids, thereby lessening the negative impact on growth.

What are chronic inflammatory connective tissue diseases (CTD), and how do biologic therapies help children affected by these conditions?

Chronic inflammatory connective tissue diseases (CTD) are a group of conditions, such as juvenile idiopathic arthritis (JIA), characterized by long-term inflammation that affects various tissues and organs. These conditions can significantly impact a child's growth and development. Biologic therapies are offering hope for improved outcomes by targeting the underlying inflammation and reducing the need for steroids, which can further inhibit growth. By addressing the root causes and consequences of inflammation, these therapies aim to restore normal growth velocity and improve overall well-being in children with CTD.

Child climbing a ladder of building blocks towards a star, symbolizing growth with biologic therapy.

Battling Growth Inhibition: How Biologic Therapies Help Kids with Chronic Inflammatory Diseases

Q: What are TNF-α and IL-6, and why are they important targets for biologic therapies?

Tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) are specific molecules, also known as cytokines, that play a key role in driving inflammation in chronic inflammatory conditions. By selectively blocking these molecules, biologics can effectively reduce inflammation with potentially fewer widespread side effects. TNF-α and IL-6 are targeted because of their significant contribution to the inflammatory process, making them key targets for therapeutic intervention in conditions like juvenile idiopathic arthritis (JIA).

Elliot Brynn in Health & Wellness December 2025 • 4 min read.

"Discover how biologic treatments can combat growth problems in children with chronic inflammatory conditions, offering hope for improved development and well-being."

Chronic inflammatory conditions, like juvenile idiopathic arthritis (JIA), present numerous challenges for children. One of the most concerning complications is the inhibition of growth velocity. Inflammation within the musculoskeletal system and the use of glucocorticoid therapy can significantly impact a child's growth, making it crucial to find effective treatments that address both the disease and its impact on development.

Traditionally, treatments have focused on managing inflammation, often relying on corticosteroids to reduce disease activity. While these medications can be effective, they also come with significant side effects, including further growth suppression. This creates a difficult balancing act: controlling the disease while minimizing harm to the child's growth and overall well-being.

In recent years, biologic therapies have emerged as a promising approach. These medications target specific components of the immune system, offering a more precise way to manage inflammation with potentially fewer side effects. This article will delve into how biologic therapies are influencing growth patterns in children with chronic inflammatory connective tissue diseases, providing insights into the potential for these treatments to restore normal development.

How Do Biologic Therapies Restore Growth in Children with CTD?

Child climbing a ladder of building blocks towards a star, symbolizing growth with biologic therapy.

Biologic therapies represent a significant advancement in treating chronic inflammatory conditions in children. Unlike traditional treatments that broadly suppress the immune system, biologics target specific molecules, such as tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6), which are key drivers of inflammation. By selectively blocking these molecules, biologics can effectively reduce inflammation with potentially fewer widespread side effects.

The benefits of biologic therapies extend beyond just managing inflammation; they also have a positive impact on growth. The connection between inflammation, steroid use, and growth inhibition is complex, but it's clear that reducing inflammation and minimizing steroid exposure are essential for restoring normal growth velocity. Here’s how biologic therapies achieve this:

Directly Inhibiting Inflammation: Biologics reduce inflammation within the musculoskeletal system, mitigating its direct impact on growth plates and hormone production.
Reducing Reliance on Glucocorticoids: By effectively controlling inflammation, biologics allow doctors to lower the doses of glucocorticoids (GCS), or even eliminate them entirely. This reduces the harmful effects of steroids on growth.
Normalizing Hormone Levels: Chronic inflammation can disrupt the secretion of growth hormone (GH) and insulin-like growth factor (IGF), both crucial for growth. Biologics help restore a more balanced hormonal environment.

A study published in Reumatologia examined the impact of biologic therapy on growth in children with chronic inflammatory connective tissue diseases (CTD). The researchers reviewed data from 24 patients treated with TNF-α blockers and an IL-6 receptor blocker. They found that growth velocity accelerated in 70.1% of patients during biologic treatment, with a mean height-SDS improvement of 0.51 ±0.58 between the start of treatment and two years later. Notably, 47% of patients were able to reduce their daily doses of GCS to 0 mg/kg/day.

The Future of Growth in Pediatric CTD

Biologic therapies offer a promising path forward for children with chronic inflammatory diseases who struggle with growth inhibition. By targeting inflammation and reducing reliance on steroids, these treatments can help restore normal growth velocity and improve overall development. As research continues and new therapies emerge, the outlook for children with CTD becomes increasingly hopeful, ensuring they have the opportunity to reach their full potential.