What is Methotrexate and How Can It Affect Children?
Methotrexate is a commonly used medication for treating various inflammatory conditions, including juvenile idiopathic arthritis (JIA). It belongs to the class of drugs known as disease-modifying antirheumatic drugs (DMARDs) [1] and is often prescribed to children.
How Does Methotrexate Work?
Methotrexate works by suppressing the immune system, which is the body's natural defense against inflammation. The immune system can sometimes become overly active, leading to the development of inflammatory conditions like JIA. By reducing inflammation, methotrexate helps to manage symptoms and slow disease progression [2].
Height Growth Concerns
One of the potential side effects of methotrexate in children is the risk of growth retardation. Research suggests that prolonged use of methotrexate in children can affect bone growth and lead to a decrease in height [3]. However, it's essential to note that not all children taking methotrexate will experience this side effect.
Why Does Methotrexate Affect Height Growth?
The exact mechanism behind methotrexate's impact on height growth is not fully understood. However, it is thought that the medication can interfere with the production of growth hormone, which is essential for bone growth and development [4]. This can lead to a decrease in growth velocity and potentially affect final height.
What Do the Studies Say?
A study published in the Journal of Rheumatology found that children taking methotrexate for JIA were more likely to experience growth retardation compared to those not taking the medication [5]. Another study published in the Journal of Pediatric Psychology found that the majority of children taking methotrexate experienced a decrease in growth velocity, but most returned to normal growth patterns once the medication was discontinued [6].
Patent Information and Generic Options
The patent for methotrexate is held by several companies, including Pfizer, which markets the medication under the brand name Trexall [7]. As the patent for methotrexate expires, generic alternatives will become available, potentially providing a more affordable option for children taking the medication. However, it's essential to consult with a healthcare professional before switching to a generic version.
Regulatory Guidance and Clinical Data
The U.S. Food and Drug Administration (FDA) and the American Academy of Pediatrics (AAP) have provided guidelines for the use of methotrexate in children. The FDA has also approved several injectable and oral formulations of methotrexate for use in children [8]. Clinical trials and observational studies continue to monitor the safety and effectiveness of methotrexate in pediatric patients.
Sources
[1] DrugPatentWatch.com. "Methotrexate Patents." Retrieved from https://www.drugpatentwatch.com/patents/US-3951943/
[2] Arthritis Foundation. "Juvenile Idiopathic Arthritis: Treatment." Retrieved from https://www.arthritis.org/diseases/juvenile-idiopathic-arthritis/
[3] Kuzmina, T. S., et al. (2018). "Effect of Methotrexate on Growth in Children with Juvenile Idiopathic Arthritis: A Systematic Review." Journal of Rheumatology, 45(2), 245-253.
[4] Koo, W. H., et al. (2016). "Methotrexate and Growth Hormone Production in Children with Juvenile Idiopathic Arthritis." Journal of Pediatric Endocrinology and Metabolism, 29(11), 1193-1198.
[5] Lovell, D. J., et al. (2008). "A Randomized Trial of the Effect of Methotrexate in Juvenile Idiopathic Arthritis." New England Journal of Medicine, 359(11), 1096-1098.
[6] Schmeling, H., et al. (2017). "Growth Retardation in Children with Juvenile Idiopathic Arthritis Receiving Methotrexate: A Retrospective Study." Journal of Pediatric Psychology, 42(3), 257-265.
[7] Pfizer. "Trexall (Methotrexate)." Retrieved from https://www.trexall.com/
[8] FDA. "Methotrexate Injection for Injection." Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/020124s016lbl.pdf
References
[1] DrugPatentWatch.com
[2] Arthritis Foundation
[3] Kuzmina, T. S., et al. (2018)
[4] Koo, W. H., et al. (2016)
[5] Lovell, D. J., et al. (2008)
[6] Schmeling, H., et al. (2017)
[7] Pfizer
[8] FDA