Paediatric Rheumatology
Body mass index associated with glucocorticoid-related weight gain in children with rheumatic disease on high-dose prednisone
R.X. Pang1, M.R. Miller2, H. Park3, S. Wells4, E. Demirkaya5, M.J. Rieder6, R.A. Berard7
- Department of Paediatrics, Western University; Schulich School of Medicine and Dentistry, Western University; and Department of Physiology and Pharmacology, Western University, London, ON, Canada. renee.pang@lhsc.on.ca
- Department of Paediatrics, Western University, and Children’s Health Research Institute, London, ON, Canada.
- Children’s Health Research Institute, London, ON, and Faculty of Medicine, University of Ottawa, ON, Canada.
- Children’s Health Research Institute, London, ON, Canada.
- Department of Paediatrics, Western University; Schulich School of Medicine and Dentistry, Western University, London, ON; and Children’s Health Research Institute, London, ON, Canada.
- Department of Paediatrics, Western University; Schulich School of Medicine and Dentistry, Western University; Department of Physiology and Pharmacology, Western University; and Children’s Health Research Institute, London, ON, Canada.
- Department of Paediatrics, Western University; Schulich School of Medicine and Dentistry, Western University, London, ON; and Children’s Health Research Institute, London, ON, Canada.
CER19100
Paediatric Rheumatology
PMID: 41328600 [PubMed]
Received: 14/07/2025
Accepted : 30/09/2025
In Press: 27/11/2025
Abstract
OBJECTIVES:
To evaluate the relationship between patient variables that affect pharmacokinetic variability with glucocorticoid (GC)-related weight gain within the first 12 months of starting prednisone therapy.
METHODS. We conducted a retrospective chart review of children aged <18 years diagnosed with rheumatic disease treated with moderate to high-dose prednisone therapy at a single Canadian paediatric academic hospital between January 1, 2010, and December 31, 2020. Using a binary logistic regression, eGFR, initial Body Mass Index (BMI), transaminitis and albumin were evaluated as predictors of GC-related obesity (defined as weight gain greater than 20% and BMI z-score ≥1.88 or >95%ile after 12 months of treatment) was evaluated.
RESULTS:
Data for sixty-two patients were included in this analysis with 18 (29%) systemic JIA, (6%) other JIA subtypes, 22 (36%) SLE, and 8 (13%) JDM patients, and the remaining patients diagnosed with connective tissue disease and other inflammatory disorders (n=10, 16%). Eighteen (29%) patients met criteria for GC-induced obesity by 12 months of therapy. Greater BMI z-score prior to initiation of GC-therapy was associated with greater risk of developing GC-induced obesity (OR=2.35, 95%CI=1.39-3.96, p<0.001).
CONCLUSIONS:
Greater BMI was a predictor of severe GC-related obesity for children with rheumatic disease requiring moderate to high-dose prednisone therapy. Further work is required to determine methods for individualised prednisone dosing, and interventions to mitigate risk for weight gain.
