Document Detail


Methotrexate as single therapy in Crohn's disease: is its long-term efficacy limited?
MedLine Citation:
PMID:  18343615     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine the efficacy and patient tolerance of parenteral methotrexate in the treatment of Crohn's disease at a dose of 25mg per week for three months, then at 15-25mg per week as maintenance therapy. PATIENTS AND METHODS: Thirty-five patients (27 women, eight men; mean age 36 years) with steroid-dependent Crohn's disease were included in the study after failure of azathioprine in 34 cases. Clinical remission was defined as a Harvey-Bradshaw disease-activity index less than or equal to 4 and complete weaning from steroids. RESULTS: At the end of the three-month induction treatment, the Harvey-Bradshaw index decreased significantly (4.6+/-2.9 versus 9.4+/-5.2; P=0.0001), as did serum CRP (24+/-27 versus 43+/-45 mg/L; P=0.01) and prednisone dose (5.63+/-7.3 versus 21.1+/-18.7 mg/L; P=0.00001). The mean maintenance dose of methotrexate was 20.3+/-3.8 mg per week. The rate of clinical remission was 50% at three months and 28% at one year and two years. Nine patients had an adverse event attributed to methotrexate that led to drug withdrawal in six cases (17%). CONCLUSION: Our findings suggest that, for steroid-dependent Crohn's disease which has failed to respond to thiopurines, long-term methotrexate remains effective in fewer than one in three patients.
Authors:
C Charpignon; P Beau
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Publication Detail:
Type:  Journal Article     Date:  2008-03-17
Journal Detail:
Title:  Gastroentérologie clinique et biologique     Volume:  32     ISSN:  0399-8320     ISO Abbreviation:  Gastroenterol. Clin. Biol.     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-04-04     Completed Date:  2008-06-26     Revised Date:  2009-04-16    
Medline Journal Info:
Nlm Unique ID:  7704825     Medline TA:  Gastroenterol Clin Biol     Country:  France    
Other Details:
Languages:  eng     Pagination:  153-7     Citation Subset:  IM    
Affiliation:
Service d'hépatogastroentérologie et assistance nutritive, hôpital Jean-Bernard, 86021 Poitiers, France.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Anti-Inflammatory Agents / therapeutic use
C-Reactive Protein / analysis
Cohort Studies
Crohn Disease / classification,  drug therapy*
Drug Administration Schedule
Female
Follow-Up Studies
Glucocorticoids / therapeutic use
Humans
Immunosuppressive Agents / administration & dosage,  adverse effects,  therapeutic use*
Longitudinal Studies
Male
Methotrexate / administration & dosage,  adverse effects,  therapeutic use*
Middle Aged
Prednisone / therapeutic use
Remission Induction
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents; 0/Glucocorticoids; 0/Immunosuppressive Agents; 53-03-2/Prednisone; 59-05-2/Methotrexate; 9007-41-4/C-Reactive Protein
Comments/Corrections
Comment In:
Gastroenterol Clin Biol. 2009 Jan;33(1 Pt 1):21-2   [PMID:  18977624 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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