The use of methotrexate for treatment of inflammatory bowel disease in clinical practice

Saibeni, Simone; Bollani, S.; Losco, Alessandra; Michielan, Andrea; Sostegni, R.; Devani, Massimo; Lupinacci, G.; Pirola, L.; Cucino, Claudia; Meucci, G.; Basilisco, Guido; D’Incà, R.; Bruno, Savino

doi:10.1016/j.dld.2011.09.015

Cited by 53 publications

(37 citation statements)

References 25 publications

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“…The rate of use of MTX in the SIBDC was 13.1%, which is higher than previously published [8]. This rate was higher for CD (17.4%) than for UC (7.2%).…”

Section: Discussioncontrasting

confidence: 51%

“…Limited data on the effectiveness of MTX in clinical practice is available, as the use of the drug is limited. In a recent retrospective analysis, MTX had been administered only to 2.1% of patients, despite effectiveness rates, 64.1% in CD patients and 47.8% in ulcerative colitis (UC) patients [8, 9]. …”

Section: Introductionmentioning

confidence: 99%

“…More than 40% of IBD patients experienced side effects, mostly liver and gastro-intestinal toxicity, infections and myelotoxicity [8]. Folate supplementation decreases the rate of these side effects [8]. …”

Section: Introductionmentioning

confidence: 99%

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Efficacy, Safety and Mucosal Healing of Methotrexate in a Large Longitudinal Cohort of Inflammatory Bowel Disease Patients

Rouiller-Braunschweig

Fournier

Pittet

et al. 2017

Digestion

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Background/Aims: Evidence for the effectiveness of methotrexate (MTX) in treating inflammatory bowel disease (IBD) is still incomplete. This study assessed the effectiveness, safety and mucosal healing in IBD patients treated with MTX in the Swiss IBD Cohort. Methods: Efficacy was defined by physician assessment or by CD activity index <150 points for Crohn’s disease (CD) or Modified Truelove and Witts activity index <4 points for ulcerative colitis (UC), measured at least after 3 months of MTX therapy. Mucosal healing was evaluated after 3 months or more of therapy. Results: MTX was administered to 341 patients (262 CD; 79 UC) out of 2,660 patients. MTX effectiveness was 59.5% (128/215) in CD and 40.0% (24/60) in UC (chi² = 7.2409, p = 0.007). Among patients on MTX therapy at the time of analysis, remission was obtained in 87.4% (76/87) and 69.2% (9/13) for CD and UC patients respectively. The median duration of MTX therapy was 40 months for CD and 15 months for UC. Occurrence of adverse events was the first reason for treatment discontinuation (39.4% of all cases). The rate of mucosal healing with MTX was 9.5% for CD and 25% for UC patients respectively. Conclusion: MTX therapy was effective for the induction and maintenance therapy in IBD patients, with only a modest mucosal healing ability.

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“…The rate of use of MTX in the SIBDC was 13.1%, which is higher than previously published [8]. This rate was higher for CD (17.4%) than for UC (7.2%).…”

Section: Discussioncontrasting

confidence: 51%

Section: Introductionmentioning

confidence: 99%

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Efficacy, Safety and Mucosal Healing of Methotrexate in a Large Longitudinal Cohort of Inflammatory Bowel Disease Patients

Rouiller-Braunschweig

Fournier

Pittet

et al. 2017

Digestion

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“…This effect is used for treatment of various diseases. Methotrexate 45 has demonstrated effective antineoplastic activity and thus, it is used in the treatment of certain forms of cancer, psoriasis, rheumatoid arthritis, lupus, inflammatory bowel disease, and scleroderma (van den Hoogen, Boerbooms, and van de Putte 1989;Scully, Anderson, and Cannon 1991;Murad et al 1993;Van Dooren-Greebe et al 1994;Kuhn et al 2002;Martínková et al 2007;Saibeni et al 2012). Methotrexate is less toxic than other chemotherapeutic drugs.…”

mentioning

confidence: 99%

“…Methotrexate is less toxic than other chemotherapeutic drugs. Moreover, it is the only cytostatic, 50 which has an antagonist, tetrahydrofolate leucovorin, which can minimize its side effects, and therefore it can be administrated at high dosage by a particular schedule (van den Hoogen, Boerbooms, and van de Putte 1989; Martínková et al 2007;Devlin 2011;Saibeni et al 2012).…”

mentioning

confidence: 99%

Determination of Methotrexate at a Silver Solid Amalgam Electrode by Differential Pulse Voltammetry

Janíková-Bandžuchová¹,

Šelešovská²

2015

Analytical Letters

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Methotrexate for induction of remission in ulcerative colitis

Chande

Wang

MacDonald

et al. 2014

Cochrane Database of Systematic Reviews

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Although methotrexate was well-tolerated, the studies showed no benefit for methotrexate over placebo or active comparators. The results for efficacy outcomes between methotrexate and placebo, methotrexate and 6-mercaptopurine and methotrexate and 5-aminosalicylic acid were uncertain. Whether a higher dose or parenteral administration would be effective for induction therapy is unknown. At present there is no evidence supporting the use of methotrexate for induction of remission in active ulcerative colitis. A trial in which larger numbers of patients receive a higher dose of oral methotrexate should be considered. Currently there are two large ongoing placebo-controlled trials (METEOR and MERIT-UC) assessing the efficacy and safety of intramuscular or subcutaneous methotrexate in patients with active UC which may help resolve the evidence supporting the use of methotrexate as therapy for active of ulcerative colitis.

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The use of methotrexate for treatment of inflammatory bowel disease in clinical practice

Cited by 53 publications

References 25 publications

Efficacy, Safety and Mucosal Healing of Methotrexate in a Large Longitudinal Cohort of Inflammatory Bowel Disease Patients

Efficacy, Safety and Mucosal Healing of Methotrexate in a Large Longitudinal Cohort of Inflammatory Bowel Disease Patients

Determination of Methotrexate at a Silver Solid Amalgam Electrode by Differential Pulse Voltammetry

Methotrexate for induction of remission in ulcerative colitis

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