Therapy update
Methotrexate in Crohn's disease
| The first 150 words of the full text of this article appear below. |
A minority of patients with Crohn's have disease refractory to or dependent on corticosteroids who are inappropriate for surgery; most will also have failed to respond to aminosalicylates, antibiotics, and/or a liquid formula diet. Firstline immunomodulatory therapy, given to initiate and maintain remission and allow tapering of steroid therapy, is usually azathioprine or 6-mercaptopurine. Unfortunately, approximately 20% of patients are resistant to or intolerant of thiopurines, and their management provides a difficult therapeutic challenge. The possible benefits of mycophenolate mofetil are unconfirmed, while infliximab is expensive and unproved in its long term efficacy and safety.
| Table Removed (Available Only in the Full Text) |
Methotrexate is of proven value in psoriasis and rheumatoid arthritis.1 2 Since its effects in Crohn's disease were first reported in an open trial 12 years ago,3 several uncontrolled and five controlled studies have further defined its role.4-8
Mechanism of actionMethotrexate and its breakdown products inhibit several enzymes in
the metabolic pathway of folic acid.9 While
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
This article has been cited by other articles:
-
(2001). Maintenance drugs for inflammatory bowel disease. DTB
39: 91-95
[Abstract] [Full Text]
- Full Text
- Full Text (PDF)
- Alert me when this article is cited
- Alert me if a correction is posted
- Citation Map
Services
- Email this link to a friend
- Similar articles in this journal
- Similar articles in PubMed
- Add article to my folders
- Download to citation manager
- Request Permissions
Citing Articles
Google Scholar
PubMed
Topic Collections
Bookmark with
Register for free content
The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.
Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.
