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Related Experiment Videos

Methotrexate in refractory Crohn's disease.

L Vandeputte1, G D'Haens, F Baert

  • 1Department of Gastroenterology, University Hospital Gasthuisberg, Leuven, Belgium.

Inflammatory Bowel Diseases
|February 24, 1999
PubMed
Summary

Methotrexate showed initial effectiveness in 70% of refractory Crohn's disease patients, allowing steroid reduction. However, long-term remission maintenance with methotrexate appears less convincing in this patient group.

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Area of Science:

  • Gastroenterology
  • Immunology
  • Pharmacology

Background:

  • Refractory Crohn's disease (CD) poses treatment challenges.
  • Methotrexate has shown potential in managing difficult CD cases.

Purpose of the Study:

  • To evaluate the efficacy and safety of parenteral methotrexate in patients with refractory or corticodependent Crohn's disease.
  • To assess the impact of methotrexate on corticosteroid use in CD patients.

Main Methods:

  • Retrospective analysis of 20 patients with active CD resistant or intolerant to azathioprine.
  • Patients received parenteral methotrexate and were monitored for clinical response (Harvey-Bradshaw index) and steroid use.
  • Assessment occurred at 12 weeks, 6, 9, and 12 months.

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Main Results:

  • A 70% clinical response rate was observed at 12 weeks (14/20 patients).
  • Response rates declined over time; long-term remission maintenance was less consistent.
  • Methotrexate facilitated corticosteroid tapering in 85% and discontinuation in 60% by 6 months.
  • Side effects were generally mild, leading to discontinuation in only two patients.

Conclusions:

  • Parenteral methotrexate is effective for short-term clinical response in refractory CD patients.
  • Methotrexate can significantly reduce corticosteroid dependency in CD.
  • Long-term efficacy of methotrexate for maintaining remission in refractory CD warrants further investigation.