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Methotrexate in paediatric ulcerative colitis: a retrospective survey at a single tertiary referral centre.
MedLine Citation:
PMID:  20937047     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND: Patients with ulcerative colitis often receive thiopurines as immunomodulators (IMs) to maintain remission and avoid corticosteroids. If unresponsive or intolerant to these agents, patients are treated with methotrexate, an antimetabolite never assessed in paediatric ulcerative colitis.
AIM: To describe the experience with methotrexate in children with ulcerative colitis.
METHODS: Thirty-two patients (median age 13.9 years) received methotrexate. Pediatric Ulcerative Colitis Activity Index (PUCAI) and use of corticosteroids were the main outcomes evaluated at baseline and at 3, 6 and 12 months.
RESULTS: Indications to methotrexate were azathioprine unresponsiveness in 18 patients, azathioprine intolerance/toxicity in 10 and spondyloarthropathy in four. Response or remission was achieved in 72%, 63% and 50% of patients at 3, 6 and 12 months respectively. Mean PUCAI were 49.5 ± 23.3 at baseline and 32.9 ± 21.9, 29.5 ± 21.8 and 29.4 ± 19.9 at 3, 6 and 12 months respectively (P: 0.03). At the beginning of methotrexate, 16 patients (50%) received corticosteroids that were discontinued in 13 of them (81%) by 6 months. At the end of the study, 11 patients (33%) needed short courses of corticosteroids for disease relapse.
CONCLUSIONS: Methotrexate may be useful in treating children with ulcerative colitis, although large, controlled trials are warranted to define better its effectiveness.
Authors:
M Aloi; G Di Nardo; F Conte; L Mazzeo; N Cavallari; F Nuti; S Cucchiara; L Stronati
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Publication Detail:
Type:  Journal Article     Date:  2010-08-16
Journal Detail:
Title:  Alimentary pharmacology & therapeutics     Volume:  32     ISSN:  1365-2036     ISO Abbreviation:  Aliment. Pharmacol. Ther.     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8707234     Medline TA:  Aliment Pharmacol Ther     Country:  England    
Other Details:
Languages:  eng     Pagination:  1017-22     Citation Subset:  IM    
Copyright Information:
© 2010 Blackwell Publishing Ltd.
Affiliation:
Department of Pediatrics, Sapienza University of Rome, Italy.
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