Sustained Clinical Benefit and Tolerability of Methotrexate Monotherapy After Thiopurine Therapy in Patients With Crohn's Disease

Adverse events in IBD: to stop or continue immune suppressant and biologic treatment

“…These reactions are typically mild and occur shortly after drug administration. Fatigue occurs in 2–6% of patients [61,62]. Stomatitis occurs in 6% of patients and alopecia in 1% [63].…”

“…One of 174 patients developed cytomegalovirus infection and discontinued therapy. No other infections were reported [61]. In addition, a case–control study of 100 IBD patients from a single center was unable to detect an increased risk of infection associated with MTX use in patients with IBD [23].…”

Review article: The pharmacokinetics and pharmacodynamics of drugs used in inflammatory bowel disease treatment

“…Previous studies had reported that monotherapy MTX was effective in inducing remission and in short-term maintenance therapy. Sustained therapeutic benefit of MTX was estimated to be 63 % after 1 year and 47 % after 2 years of therapy [166][167][168]. The ECCO recommendations for MTX use in CD patients are highlighted in Table 5 Calcineurin inhibitors…”

Recomendaciones del Grupo Español de Trabajo de Enfermedad de Crohn y Colitis Ulcerosa (GETECCU) sobre el uso de metotrexato en la enfermedad inflamatoria intestinal

“…Es más, en el estudio de Feagan, cuando se perdía la respuesta con 15 mg/semana, la reintroducción de 25 mg/semana recuperaba la respuesta en la mayoría 22 . Como ocurre con otros fármacos en las EII una importante limitación es la pérdida de eficacia que es muy frecuente y que hace que a largo plazo solo una proporción de pacientes mantienen la respuesta, como algo menos de un tercio en un estudio a tres años 26 o un quinto en otro estudio a cinco años 28 .…”