Title

Methotrexate use in juvenile idiopathic arthritis and its impact on growth plate development: A prospective observational cohort study

Authors

Shreyansh Ahirwar¹*, Prashant Panale², Chetan Shokeen³, Nitin Pratap Shishodia⁴, Puneet Kamra⁵, Sujit Kumar Singh⁶ & Mrudul Kyada⁵

Affiliation

¹Department of Dentistry, District Hospital, Vidisha, Madhya Pradesh, India; ²Department of Pediatrics, Military Hospital, Bareilly, Uttar Pradesh, India; ³Department of Pharmacology, Karnataka Medical College and Research Institute, Hubballi, Karnataka, India; ⁴Department of Oral Medicine and Radiology, Seema Dental College and Hospital, Rishikesh, Uttarakhand, India; ⁵Department of Orthopedics, SGT Medical College and Research Institute, Gurugram, Haryana, India; ⁶Department of Orthopedics, ASJSATDS Medical College, Fatehpur, Uttar Pradesh, India; *Corresponding author

Email

Shreyansh Ahirwar - E-mail: drshreyansh.ahirwar@gmail.com
Prashant Panale - E-mail: poz129@gmail.com
Chetan Shokeen - E-mail: chetanshokeen4@gmail.com
Nitin Pratap Shishodia - E-mail: nitinshishodia48@gmail.com
Puneet Kamra - E-mail: puneetpgi292@gmail.com
Sujit Kumar Singh - E-mail: drsujitkrsingh@gmail.com
Mrudul Kyada - E-mail: mrudulkyada@ymail.com

Article Type

Research Article

Date

Received August 1, 2025; Revised August 31, 2025; Accepted August 31, 2025, Published August 31, 2025

Abstract

Juvenile Idiopathic Arthritis (JIA) is a chronic inflammatory disease that can disrupt normal skeletal growth in children. Methotrexate (MTX) is widely used as a disease-modifying therapy in JIA, has uncertain effects on the developing growth plate and bone elongation. Hence, we enrolled 40 children with JIA, dividing them equally into MTX-exposed and non-MTX groups and evaluated growth plate morphology (via imaging), growth velocity (using height-for-age Z-scores) and biochemical markers (IGF-1, ALP, Vitamin D) over 12 months. The MTX group showed significantly reduced growth velocity (ΔZ = 0.31 vs. 0.58, p < 0.01), more epiphyseal irregularities on MRI (35% vs. 5%) and lower IGF-1 and ALP levels compared to controls. Although no severe skeletal defects were found, these findings suggest MTX may subtly affect growth, highlighting the need for careful longitudinal monitoring in treated children.

Keywords

Juvenile idiopathic arthritis, methotrexate, growth plate, growth velocity, IGF-1, MRI, pediatric rheumatology

Citation

Ahirwar et al. Bioinformation 21(8): 2680-2683 (2025)

Edited by

Akshaya Ojha

ISSN

0973-2063

Publisher

Biomedical Informatics

License

This is an Open Access article which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. This is distributed under the terms of the Creative Commons Attribution License.