Methotrexate for maintenance of remission in Crohn's disease

Patel, Vishal; MacDonald, John K; McDonald, John W.D.; Chande, Nilesh

doi:10.1002/14651858.cd006884

Cited by 17 publications

(21 citation statements)

References 9 publications

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“…MTX is effective for the induction173 and maintenance174 of remission in Crohn's disease and may induce mucosal healing 175 176. Evidence from a single large RCT of adult patients demonstrates that 25 mg/week of intramuscular MTX is more effective than placebo at inducing steroid-free remission at 16 weeks (39% vs 19%; p=0.025; NNT=5) 177.…”

Section: 0 Therapeutic Options In the Management Of Ibdmentioning

confidence: 99%

Guidelines for the management of inflammatory bowel disease in adults

Mowat

Cole

Windsor

et al. 2011

Gut

1,178

838

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The management of inflammatory bowel disease represents a key component of clinical practice for members of the British Society of Gastroenterology (BSG). There has been considerable progress in management strategies affecting all aspects of clinical care since the publication of previous BSG guidelines in 2004, necessitating the present revision. Key components of the present document worthy of attention as having been subject to re-assessment, and revision, and having direct impact on practice include: The data generated by the nationwide audits of inflammatory bowel disease (IBD) management in the UK in 2006, and 2008. The publication of 'Quality Care: service standards for the healthcare of people with IBD' in 2009. The introduction of the Montreal classification for Crohn's disease and ulcerative colitis. The revision of recommendations for the use of immunosuppressive therapy. The detailed analysis, guidelines and recommendations for the safe and appropriate use of biological therapies in Crohn's disease and ulcerative colitis. The reassessment of the role of surgery in disease management, with emphasis on the importance of multi-disciplinary decision-making in complex cases. The availablity of new data on the role of reconstructive surgery in ulcerative colitis. The cross-referencing to revised guidelines for colonoscopic surveillance, for the management of metabolic bone disease, and for the care of children with inflammatory bowel disease. Use of the BSG discussion forum available on the BSG website to enable ongoing feedback on the published document http://www.bsg.org.uk/forum (accessed Oct 2010). The present document is intended primarily for the use of clinicians in the United Kingdom, and serves to replace the previous BSG guidelines in IBD, while complementing recent consensus statements published by the European Crohn's and Colitis Organisation (ECCO) https://www.ecco-ibd.eu/index.php (accessed Oct 2010).

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Section: 0 Therapeutic Options In the Management Of Ibdmentioning

confidence: 99%

Guidelines for the management of inflammatory bowel disease in adults

Mowat

Cole

Windsor

et al. 2011

Gut

1,178

838

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“…Methotrexate is found to be useful through intramuscular application, not the oral route [110]. Also, combination with infliximab was not better than the use of infliximab alone [111].…”

Section: Efficacy Of the Drugs Used For Maintenance Therapymentioning

confidence: 94%

Maintenance therapy for Crohn’s disease

Önal

Beyazıt

Altınbaş

et al. 2015

European Journal of Gastroenterology & Hepatology

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Crohn's disease (CD) is a chronic, persistent, and destructive disorder with different forms of clinical behavior and the disease appears to be progressive over the long term. Providing greater levels of mucosal healing and resolution of clinical symptoms may modify the course of CD. This will often necessitate long-term therapy with immunosuppressant or biological therapies. Both these classes of drugs have side-effects and the latter are also very expensive. Identification of a subgroup of patients with a low risk of relapse and validation of the relevant predictors in various cohort studies are the key points to be able to cease immunosuppressant and/or biological therapy in patients with CD in stable remission. The individual parameters 'mucosal healing', 'deep remission', 'fecal calprotectin', and 'C-reactive protein' or various combinations of these parameters seem to be promising tools for predicting successful withdrawal of maintenance therapy.

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“…Although the differential for nausea and vomiting is large, medications are very often a culprit in the IBD patient population, especially immunomodulators. In Cochrane reviews, evaluating the efficacy of methotrexate in induction and remission of CD, the most common reported symptoms were nausea and vomiting [71,72]. In general, these events were mild and resolved with either discontinuation of the drug or additional folic acid supplementation [71].…”

Section: Nausea/vomitingmentioning

confidence: 99%

Symptom management in inflammatory bowel disease

Abraham

2015

Expert Review of Gastroenterology & Hepatology

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Patients with inflammatory bowel disease can present with a wide variety of symptoms. Most are related to disease activity and should be managed with appropriate medical therapy for inflammatory bowel disease. However, some patients may develop symptoms due to the side effects of the medications, or due to immunosuppression. In these cases, the offending medications should be discontinued until resolution of the symptoms and a few may be able to restart therapy. Symptoms can also occur as an extraintestinal manifestation of the disease or due to concomitant autoimmune-mediated disorders. Regardless of the etiology, symptoms should be addressed promptly with immediate evaluation and appropriate therapy, as a delay may lead to permanent sequela.

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Methotrexate for maintenance of remission in Crohn's disease

Cited by 17 publications

References 9 publications

Guidelines for the management of inflammatory bowel disease in adults

Guidelines for the management of inflammatory bowel disease in adults

Maintenance therapy for Crohn’s disease

Symptom management in inflammatory bowel disease

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