Abstract
Methotrexate is an antimetabolite with significant anti-inflammatory properties. As such, it has been used in a heterogeneous group of inflammatory disorders and prompted a study of its use in idiopathic inflammatory bowel disease. Eighty percent of 38 patients with refractory Crohn’s disease or chronic ulcerative colitis patients had a statistically significant clinical improvement to 25 mg of parenteral methotrexate weekly within 12 weeks. This clinical improvement was associated with steroid reductions and endoscopic and histologic improvement or normalization in a subset of patients. Seventy-seven percent of 30 patients switched to a tapered oral methotrexate dose have maintained remission with oral methotrexate at mean follow-up of approximately one year. Toxicity was generally mild and related to minor liver function abnormalities, nausea and abdominal cramping, or leukopenia, although one opportunistic infection and one case of hypersensitivity pneumonitis were noted. Moreover, given methotrexate’s known ability to induce hepatic fibrosis and cirrhosis, long term follow-up of our patients remains necessary. Additional studies will be required to define what place methotrexate will play in the treatment of idiopathic inflammatory bowel disease.
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© 1990 Kluwer Academic Publishers
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Kozarek, R.A. (1990). Use of Methotrexate for Refractory Inflammatory Bowel Disease. In: Rachmilewitz, D., Zimmerman, J. (eds) Inflammatory Bowel Diseases 1990. Developments in Gastroenterology, vol 11. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-1980-8_27
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DOI: https://doi.org/10.1007/978-94-009-1980-8_27
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