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Related Concept Videos

Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents01:29

Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents

Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel Disease...
Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids01:21

Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids

Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2 (COX-2),...
Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF01:24

Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF

Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab (Humira),...
Drugs for Treatment of Ulcerative Colitis in IBD01:29

Drugs for Treatment of Ulcerative Colitis in IBD

Ulcerative colitis is a chronic inflammatory condition primarily affecting the colon and rectum. The primary drugs used in the treatment of ulcerative colitis are aminosalicylates. They exhibit anti-inflammatory and immunosuppressive properties. They modulate inflammatory mediators and inhibit the activity of nuclear factor κB (NF-κB). Aminosalicylates also reduce inflammation by inhibiting prostaglandin and leukotriene production and decreasing neutrophil chemotaxis and superoxide generation. 
Therapeutic Drug Monitoring: Affecting Factors01:29

Therapeutic Drug Monitoring: Affecting Factors

Therapeutic Drug Monitoring (TDM) is the clinical practice of measuring specific drug levels in a patient's blood or body tissues to manage and optimize therapy. TDM is crucial for drugs with narrow therapeutic windows, like warfarin and phenytoin, where incorrect doses can lead to treatment failure or severe side effects. This monitoring ensures the dosage administered is within a safe and effective range. The factors affecting therapeutic drug monitoring include:Patient-Specific Factors:a.
Antiprotozoal Agents01:21

Antiprotozoal Agents

Leishmaniasis is a widespread parasitic disease caused by several Leishmania species. It affects millions of people each year and remains a major public health problem in endemic regions. First-line treatment relies on pentavalent antimonials, including meglumine antimoniate and sodium stibogluconate. Even so, how these drugs work has not been fully clear, especially their interaction with parasite-specific biochemical pathways. One key target is trypanothione reductase (TR), an enzyme that...

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Related Experiment Video

Updated: Jun 13, 2026

Preliminary Study on Acupuncture Combined with Grain-sized Moxibustion for Treating Rheumatoid Arthritis with Finger Joint Pain
04:50

Preliminary Study on Acupuncture Combined with Grain-sized Moxibustion for Treating Rheumatoid Arthritis with Finger Joint Pain

Published on: May 16, 2025

Methotrexate for primary biliary cirrhosis.

Vanja Giljaca1, Goran Poropat, Davor Stimac

  • 1Department of Gastroenterology, Clinical Hospital Centre Rijeka, Kresimirova 42, Rijeka, Croatia, 51000.

The Cochrane Database of Systematic Reviews
|May 14, 2010
PubMed
Summary
This summary is machine-generated.

Methotrexate does not significantly impact mortality or liver transplantation for primary biliary cirrhosis patients. While it may improve symptoms like itching, evidence is insufficient to recommend its use.

Related Experiment Videos

Last Updated: Jun 13, 2026

Preliminary Study on Acupuncture Combined with Grain-sized Moxibustion for Treating Rheumatoid Arthritis with Finger Joint Pain
04:50

Preliminary Study on Acupuncture Combined with Grain-sized Moxibustion for Treating Rheumatoid Arthritis with Finger Joint Pain

Published on: May 16, 2025

Area of Science:

  • Hepatology
  • Immunology
  • Clinical Trials

Background:

  • Methotrexate (MTX) is an immunosuppressive drug used for primary biliary cirrhosis (PBC).
  • Previous reviews indicated potential increased mortality with MTX in PBC patients.
  • Updated follow-up data from existing trials are now available.

Purpose of the Study:

  • To evaluate the efficacy and safety of methotrexate in treating primary biliary cirrhosis.
  • To assess the impact of methotrexate on mortality, liver transplantation, and other clinical outcomes.

Main Methods:

  • Systematic review of randomized clinical trials (RCTs) identified through comprehensive database searches (Cochrane Hepato-Biliary Group, CENTRAL, MEDLINE, EMBASE) up to September 2009.
  • Inclusion criteria: RCTs comparing methotrexate with placebo, no intervention, or other drugs.
  • Primary outcomes: mortality and mortality or liver transplantation combined; secondary outcomes included pruritus, fatigue, liver biochemistry, histology, and adverse events.

Main Results:

  • Four trials (370 patients) compared methotrexate with placebo/no intervention; high risk of bias was noted. No significant effect on mortality (RR 1.32) or liver transplantation was found.
  • Methotrexate showed a significant reduction in pruritus score (MD -0.17) but worsened prothrombin time (MD 1.60s).
  • One trial (85 patients) comparing methotrexate with colchicine (low risk of bias) found no significant difference in mortality or liver biopsy outcomes, but MTX improved pruritus, alkaline phosphatase, and IgM levels.

Conclusions:

  • Methotrexate demonstrates no statistically significant impact on mortality or the need for liver transplantation in primary biliary cirrhosis patients.
  • While methotrexate may offer benefits for pruritus, serum alkaline phosphatase, and immunoglobulin M levels, current evidence is insufficient for its recommendation.
  • Further high-quality research is needed to definitively establish the role of methotrexate in managing primary biliary cirrhosis.