Methotrexate for maintenance of remission in ulcerative colitis

Abstract

The available evidence is not sufficient to recommend the use of methotrexate to maintain remission in patients with ulcerative colitis. A large scale methodologically rigorous randomized controlled trial is needed. Such a study should investigate higher doses of methotrexate and parenteral administration.

Inflammatory bowel disease meta‐evidence and its challenges: is it time to restructure surgical research?

“…Twenty‐one of these were excluded (κ = 0.920, 95% CI 0.832–1.000). The 118 included papers covering 193 256 patients were allocated to one of three categories depending on their speciality focus: M (80 papers, 135 375 patients), S (28 papers, 36 521 patients) or MS (10 papers, 24 823 patients). The trial flow diagram representing the inclusion and exclusion process is shown in Fig.…”

Inflammatory bowel disease meta‐evidence and its challenges: is it time to restructure surgical research?

“…Twenty‐one of these were excluded (κ = 0.920, 95% CI 0.832–1.000). The 118 included papers covering 193 256 patients were allocated to one of three categories depending on their speciality focus: M (80 papers, 135 375 patients), S (28 papers, 36 521 patients) or MS (10 papers, 24 823 patients). The trial flow diagram representing the inclusion and exclusion process is shown in Fig.…”

Clinical Practice Guidelines for the Medical Management of Nonhospitalized Ulcerative Colitis: The Toronto Consensus

“…Meta-analyses of methotrexate for induction 97,108 or maintenance therapy 97,109 reveal the paucity of data with this agent for the treatment of UC. The only placebocontrolled RCT for induction therapy reported no statistically significant benefit of methotrexate (RR, 1.29; 95% CI, 0.95-1.75) over placebo in patients with corticosteroiddependent UC.…”

Second Korean guidelines for the management of ulcerative colitis

“…Prospective studies on the effect of MTX on UC are lacking, and the results are not consistent because of the variance of medication dosages or administrating methods. 164 165 166 According to a RCT, the effect of MTX therapy was not superior to that of placebo treatment in steroid-dependent patients when used at 12.5 mg per week by oral administration. 164 A Cochrane review concluded that evidence is insufficient to recommend MTX therapy to UC patients.…”

“… 164 A Cochrane review concluded that evidence is insufficient to recommend MTX therapy to UC patients. 166 …”

Inflammatory bowel disease meta‐evidence and its challenges: is it time to restructure surgical research?

“…Twenty‐one of these were excluded (κ = 0.920, 95% CI 0.832–1.000). The 118 included papers covering 193 256 patients were allocated to one of three categories depending on their speciality focus: M (80 papers, 135 375 patients), S (28 papers, 36 521 patients) or MS (10 papers, 24 823 patients). The trial flow diagram representing the inclusion and exclusion process is shown in Fig.…”

Clinical Practice Guidelines for the Medical Management of Nonhospitalized Ulcerative Colitis: The Toronto Consensus

“…Meta-analyses of methotrexate for induction 97,108 or maintenance therapy 97,109 reveal the paucity of data with this agent for the treatment of UC. The only placebocontrolled RCT for induction therapy reported no statistically significant benefit of methotrexate (RR, 1.29; 95% CI, 0.95-1.75) over placebo in patients with corticosteroiddependent UC.…”

Second Korean guidelines for the management of ulcerative colitis

“…Prospective studies on the effect of MTX on UC are lacking, and the results are not consistent because of the variance of medication dosages or administrating methods. 164 165 166 According to a RCT, the effect of MTX therapy was not superior to that of placebo treatment in steroid-dependent patients when used at 12.5 mg per week by oral administration. 164 A Cochrane review concluded that evidence is insufficient to recommend MTX therapy to UC patients.…”

“… 164 A Cochrane review concluded that evidence is insufficient to recommend MTX therapy to UC patients. 166 …”

Inflammatory bowel disease meta‐evidence and its challenges: is it time to restructure surgical research?

“…Twenty‐one of these were excluded (κ = 0.920, 95% CI 0.832–1.000). The 118 included papers covering 193 256 patients were allocated to one of three categories depending on their speciality focus: M (80 papers, 135 375 patients), S (28 papers, 36 521 patients) or MS (10 papers, 24 823 patients). The trial flow diagram representing the inclusion and exclusion process is shown in Fig.…”

Clinical Practice Guidelines for the Medical Management of Nonhospitalized Ulcerative Colitis: The Toronto Consensus

“…Meta-analyses of methotrexate for induction 97,108 or maintenance therapy 97,109 reveal the paucity of data with this agent for the treatment of UC. The only placebocontrolled RCT for induction therapy reported no statistically significant benefit of methotrexate (RR, 1.29; 95% CI, 0.95-1.75) over placebo in patients with corticosteroiddependent UC.…”

Second Korean guidelines for the management of ulcerative colitis

“…Prospective studies on the effect of MTX on UC are lacking, and the results are not consistent because of the variance of medication dosages or administrating methods. 164 165 166 According to a RCT, the effect of MTX therapy was not superior to that of placebo treatment in steroid-dependent patients when used at 12.5 mg per week by oral administration. 164 A Cochrane review concluded that evidence is insufficient to recommend MTX therapy to UC patients.…”

“… 164 A Cochrane review concluded that evidence is insufficient to recommend MTX therapy to UC patients. 166 …”