Use of methotrexate in inflammatory bowel disease in 2014: A User's Guide
- PMID: 25133040
- PMCID: PMC4133437
- DOI: 10.4292/wjgpt.v5.i3.113
Use of methotrexate in inflammatory bowel disease in 2014: A User's Guide
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.
Figures
References
-
- Lower EE, Baughman RP. Prolonged use of methotrexate for sarcoidosis. Arch Intern Med. 1995;155:846–851. - PubMed
-
- Suarez-Almazor ME, Belseck E, Shea B, Wells G, Tugwell P. Methotrexate for rheumatoid arthritis. Cochrane Database Syst Rev. 2000;(2):CD000957. - PubMed
-
- Wenzel J. Methotrexate in systemic lupus erythematosus. Lupus. 2005;14:569. - PubMed
-
- Ardizzone S, Bollani S, Manzionna G, Imbesi V, Colombo E, Bianchi Porro G. Comparison between methotrexate and azathioprine in the treatment of chronic active Crohn’s disease: a randomised, investigator-blind study. Dig Liver Dis. 2003;35:619–627. - PubMed
-
- Oren R, Arber N, Odes S, Moshkowitz M, Keter D, Pomeranz I, Ron Y, Reisfeld I, Broide E, Lavy A, et al. Methotrexate in chronic active ulcerative colitis: a double-blind, randomized, Israeli multicenter trial. Gastroenterology. 1996;110:1416–1421. - PubMed
Publication types
LinkOut - more resources
Full Text Sources
Other Literature Sources