Efficacy, Safety and Mucosal Healing of Methotrexate in a Large Longitudinal Cohort of Inflammatory Bowel Disease Patients.
Details
Serval ID
serval:BIB_209296D595B6
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Efficacy, Safety and Mucosal Healing of Methotrexate in a Large Longitudinal Cohort of Inflammatory Bowel Disease Patients.
Journal
Digestion
ISSN
1421-9867 (Electronic)
ISSN-L
0012-2823
Publication state
Published
Issued date
11/2017
Peer-reviewed
Oui
Volume
96
Number
4
Pages
220-227
Language
english
Notes
Publication types: Evaluation Studies ; Journal Article
Publication Status: ppublish
Publication Status: ppublish
Abstract
Evidence for the effectiveness of methotrexate (MTX) in treating inflammatory bowel disease (IBD) is still incomplete. This study assessed the effectiveness, safety and mucosal healing in IBD patients treated with MTX in the Swiss IBD Cohort.
Efficacy was defined by physician assessment or by CD activity index <150 points for Crohn's disease (CD) or Modified Truelove and Witts activity index <4 points for ulcerative colitis (UC), measured at least after 3 months of MTX therapy. Mucosal healing was evaluated after 3 months or more of therapy.
MTX was administered to 341 patients (262 CD; 79 UC) out of 2,660 patients. MTX effectiveness was 59.5% (128/215) in CD and 40.0% (24/60) in UC (chi2 = 7.2409, p = 0.007). Among patients on MTX therapy at the time of analysis, remission was obtained in 87.4% (76/87) and 69.2% (9/13) for CD and UC patients respectively. The median duration of MTX therapy was 40 months for CD and 15 months for UC. Occurrence of adverse events was the first reason for treatment discontinuation (39.4% of all cases). The rate of mucosal healing with MTX was 9.5% for CD and 25% for UC patients respectively.
MTX therapy was effective for the induction and maintenance therapy in IBD patients, with only a modest mucosal healing ability.
Efficacy was defined by physician assessment or by CD activity index <150 points for Crohn's disease (CD) or Modified Truelove and Witts activity index <4 points for ulcerative colitis (UC), measured at least after 3 months of MTX therapy. Mucosal healing was evaluated after 3 months or more of therapy.
MTX was administered to 341 patients (262 CD; 79 UC) out of 2,660 patients. MTX effectiveness was 59.5% (128/215) in CD and 40.0% (24/60) in UC (chi2 = 7.2409, p = 0.007). Among patients on MTX therapy at the time of analysis, remission was obtained in 87.4% (76/87) and 69.2% (9/13) for CD and UC patients respectively. The median duration of MTX therapy was 40 months for CD and 15 months for UC. Occurrence of adverse events was the first reason for treatment discontinuation (39.4% of all cases). The rate of mucosal healing with MTX was 9.5% for CD and 25% for UC patients respectively.
MTX therapy was effective for the induction and maintenance therapy in IBD patients, with only a modest mucosal healing ability.
Keywords
Adolescent, Adult, Aged, Aged, 80 and over, Child, Colitis, Ulcerative/drug therapy, Crohn Disease/drug therapy, Female, Humans, Immunosuppressive Agents/therapeutic use, Induction Chemotherapy/methods, Induction Chemotherapy/statistics & numerical data, Intestinal Mucosa/drug effects, Longitudinal Studies, Maintenance Chemotherapy/methods, Maintenance Chemotherapy/statistics & numerical data, Male, Methotrexate/therapeutic use, Middle Aged, Retrospective Studies, Time Factors, Treatment Outcome, Wound Healing/drug effects, Young Adult, Crohn’s disease, Methotrexate, Ulcerative colitis
Pubmed
Web of science
Create date
30/10/2017 10:33
Last modification date
20/08/2019 12:56
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