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Review
. 2014 Aug 6;5(3):113-21.
doi: 10.4292/wjgpt.v5.i3.113.

Use of methotrexate in inflammatory bowel disease in 2014: A User's Guide

Arun Swaminath  1 , Raja Taunk  1 , Garrett Lawlor  1
Affiliations
Review

Use of methotrexate in inflammatory bowel disease in 2014: A User's Guide

Arun Swaminath et al. World J Gastrointest Pharmacol Ther. .

Abstract

Methotrexate has been used an immunomodulator in many autoimmune diseases, including inflammatory bowel disease. However, many physicians are unfamiliar or uncomfortable with its use in the management of inflammatory bowel disease. We summarize the data for use of methotrexate in common clinical scenarios: (1) steroid dependant Crohn's disease (CD); (2) maintenance of remission in steroid free CD; (3) azathioprine failures in CD; (4) in combination therapy with Anti-TNF agents in CD; (5) decreasing antibody formation to Anti-TNF therapy in CD; (6) management of fistulizing disease in CD; and (7) as well as induction and maintenance of remission in ulcerative colitis. An easy to use algorithm is provided for the busy clinician to access and safely prescribe methotrexate for their inflammatory bowel disease patients.

Keywords: Crohn’s disease; Immunomodulators; Inflammatory bowel disease; Methotrexate; Methotrexate user’s guide; Ulcerative colitis.

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Figures

Figure 1
Figure 1
Algorithm for evidence-based use of methotrexate in inflammatory bowel disease. AZA: Azathioprine.
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