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Oral methotrexate in ulcerative colitis.
J R F Cummings1, K R Herrlinger, S P L Travis
1Gastroenterology Unit, University of Oxford, Radcliffe Infirmary, Oxford, UK. fraserc@well.ox.ac.uk
Alimentary Pharmacology & Therapeutics
|February 16, 2005
Summary
Methotrexate (MTX) is moderately effective and well-tolerated for ulcerative colitis (UC) patients. It helps achieve remission in 42% of patients, with a good response in 54%.
Area of Science:
- Gastroenterology
- Immunology
- Pharmacology
Background:
- Efficacy of methotrexate for ulcerative colitis (UC) management remains unclear.
- Audit performed to investigate the role of methotrexate in UC treatment.
Purpose of the Study:
- To investigate the role of methotrexate in the management of ulcerative colitis.
- Evaluate efficacy and tolerability of oral methotrexate in UC patients.
Main Methods:
- Retrospective audit of 50 patients with UC treated with oral methotrexate.
- Efficacy defined by remission (steroid withdrawal) and response (steroid reduction).
Main Results:
- 42% of patients achieved remission; 54% had a good response.
- 23% experienced side-effects, leading 10% to discontinue treatment.
- In patients with prior azathioprine failure, 3/11 achieved remission, but 4 required colectomy.
Conclusions:
- Oral methotrexate (approx. 20 mg/week) is well-tolerated and moderately effective.
- Methotrexate is a viable option for steroid-dependent or steroid-refractory UC patients.