Role of Methotrexate in the Management of Crohn Disease

Abstract

Methotrexate is effective and well tolerated in children with CD. It should be considered in those patients who do not experience a remission with standard medications because it may avoid the use of biological agents and their potential uncertain long-term side effects.

Methotrexate Following Unsuccessful Thiopurine Therapy in Pediatric Crohn's Disease

“…Due to the small numbers, these patients were analyzed together as one oral MTX treatment group and all analyses controlled for the methods of admin- (13,18,19). In univariate analyses, dosage did not influence any of the outcomes studied (i.e., steroid use, PCDAI score, growth, total adverse event rate, adverse event rate leading to MTX discontinuation).…”

“…During the 3-yr follow-up from MTX initiation, 21 (35%) of 60 patients remained well, while continuing MTX alone. In addition to the eight patients (13%) who discontinued MTX because of an adverse event, further step-up therapy was required in 31 (52%) after a median interval of 17 months (IQR[12][13][14][15][16][17][18][19][20][21][22]. Of these, infliximab treatment was commenced in 30, and one underwent intestinal resection.…”

Peripheral ulcerative keratitis in a child

“…6 The safety profile of methotrexate has been studied in children with juvenile idiopathic arthritis and Crohn's disease, and side effects, including elevated liver enzymes and neutropenia, are rare. 7,8 As illustrated by our patient's steroid-induced ocular hypertension and her susceptibility to communityacquired pneumonia while on methotrexate, it is important to monitor the side effects of therapy while one aggressively treats PUK and associated systemic disease.…”

Kronik enflamatuar barsak hastalıkları

“…Bunun haricinde steroidin erken kesilmesi ve remisyonun sa¤lanmas› için metotrexate 25 mg/ haftada kullan›lmaktad›r. Metotreksat remisyonda kullan›ld›¤› gibi indüksiyonda da kullan›lmaktad›r (53).…”