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Lung function in children and adolescents with juvenile idiopathic arthritis during long-term treatment with

Christoph Leiskau1, Angelika Thon, Monika Gappa

  • 1Division of Pediatric Pneumology, Allergology and Neonatology, Dept. of Pediatrics, Hannover Medical School, Hannover, Germany. christoph-leiskau@gmx.de

Clinical and Experimental Rheumatology
|March 14, 2012
PubMed
Abstract

Insights

Long-term methotrexate (MTX) treatment in juvenile idiopathic arthritis (JIA) patients showed some decline in lung function, specifically MMEF and DLCO. However, overall safety was confirmed, with no clinically significant lung disease observed.

Area of Science:

  • Pediatric Rheumatology
  • Pulmonary Medicine
  • Pharmacology

Background:

  • Methotrexate (MTX) is associated with pulmonary adverse events in adults with rheumatoid arthritis.
  • Long-term effects of MTX on lung function in juvenile idiopathic arthritis (JIA) require further investigation.

Purpose of the Study:

  • To evaluate the long-term impact of MTX on pulmonary function tests (PFTs) in patients diagnosed with JIA.
  • To assess the safety profile of MTX concerning respiratory health in a pediatric population.

Main Methods:

  • Retrospective chart review of 68 JIA patients treated with MTX over 14 years.
  • Analysis of annual PFT results using paired t-tests and linear regression.
  • Comparison of PFTs before MTX initiation and at various time points during treatment.

Main Results:

  • A subgroup of 37 patients showed significant decreases in mean mid-expiratory flow (MMEF) by -14.0% and diffusion capacity (DLCO) by -12.4% after 3 years of MTX.
  • The total group exhibited a -13.5% decrease in MMEF between years 3 and 4.
  • Forced expiratory volume (FEV1) slightly increased (+5.5%) between years 4 and 5; no correlation found between PFT changes, cumulative MTX dose, or JIA subtype. No patients developed clinically significant lung disease.

Conclusions:

  • Long-term MTX treatment in JIA patients may lead to modest declines in MMEF and DLCO.
  • The study supports the relative safety of long-term MTX therapy in JIA patients regarding pulmonary function.
  • Further research is recommended to monitor pulmonary function development in patients undergoing MTX therapy.

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