Effects of Juvenile Idiopathic Inflammatory Myopathies on Growth, Development, and Maturation: A Systematic Review and Metaanalysis

Objective Juvenile idiopathic inflammatory myopathies (JIIM) are autoimmune conditions that cause skin and muscle inflammation. This inflammation is thought to cause insulin resistance and disrupt various hormone axes, which may cause endocrine damage and affect pubertal development and growth. The treatment of JIIM may also affect growth and pubertal maturity. The purpose of this review is to assess the effects of JIIM on growth and pubertal development.

Methods A systematic review was conducted by searching Embase, MEDLINE, PubMed, PsycInfo, Cochrane, and Web of Science to identify studies published in English from inception to December 2024. Data were extracted regarding puberty- and development-related outcomes. Metaanalyses were conducted for outcomes measured consistently across studies, using the R package metafor (version 3.4-0).

Results Of 5838 identified unique records, 24 were included. Interrater reliability for abstract and full-text screening was κ = 0.93 and κ = 1.0, respectively. Eighteen articles discussed growth (14/18 demonstrated decreased height or growth failure). Metaanalysis of 7 studies noted the overall prevalence of growth failure is 17.90% (95% CI 10.74-25.06). Five articles reported delays of secondary sex characteristics or puberty. Five articles discussed age of menarche onset; 4 reported delays and 1 did not.

Conclusion JIIM can cause several deleterious effects on development including growth failure. The effect of hormonal changes or delayed puberty has been less well studied. Endocrine abnormalities should be actively screened for and treated. Additional research is needed to assess long-term effects.