| Title | Efficacy of methotrexate in Crohn's disease and ulcerative colitis patients unresponsive or intolerant to azathioprine/mercaptopurine. | | Author(s) | Wahed M, Louis-Auguste JR, Baxter LM, Limdi JK, McCartney SA, Lindsay JO, Bloom SL | | Institution | Department of Gastroenterology, University College London Hospitals NHS Trust, London. | | Source | Aliment Pharmacol Ther 2009 Jun 23. | | Abstract | Background Despite the wide use of azathioprine/mercaptopurine (AZA/MP) therapy in the management of both Crohn's disease (CD) and ulcerative colitis (UC), approximately 20% of patients cannot tolerate the drugs and 30% do not respond. Aim To examine the efficacy and safety profile of MTX in patients with CD or UC who are either intolerant or non-responsive to AZA/MP. Methods 131 patients with IBD treated with MTX were identified. Retrospective data was obtained by case note review. Clinical response (defined as steroid withdrawal, normalisation of previously raised CRP, or physician's clinical assessment of improvement) was assessed at 6 months. Results Clinical response in Crohn's disease occurred in 18 out of 29 patients (62%) refractory to AZA/MP, and 42 out of 70 patients (60%) intolerant to AZA/MP, with no difference between the groups (p=1.0). In UC, clinical response was seen in 7 out of 9 (78%) patients refractory to AZA/MP and 15 out of 23 (65%) intolerant to thiopurines. MTX was well tolerated in the majority of individuals. Conclusions MTX appears effective in both CD and UC patients who fail to respond or are intolerant to AZA/MP therapy. | | Language | ENG | | Pub Type(s) | JOURNAL ARTICLE
| | PubMed ID | 19552632 |
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