European experience with methotrexate treatment in Crohn’s disease
| Autor: | Juan R. Pineda, L. Sanromán, Gregorios A. Paspatis, Selwyn Odes, N. Jojic, Ioannis E. Koutroubakis, Konstantinos Papamichael, Uri Kopylov, Konstantinos H. Katsanos, I. Kaimakliotis, Christien J. van der Woude, Konstantinos Karmiris, Epameinondas V. Tsianos, Konstantina Strongili, Gerassimos J. Mantzaris, D. Bojic, Vicent Hernandez, Neofytos P. Papageorgiou, Shomron Ben-Horin, Dimitrios K. Christodoulou, Gionata Fiorino |
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| Přispěvatelé: | Gastroenterology & Hepatology |
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Kaplan-Meier Estimate Drug Administration Schedule Young Adult 03 medical and health sciences 0302 clinical medicine Crohn Disease Refractory Internal medicine medicine Humans Young adult Adverse effect Glucocorticoids Retrospective Studies Crohn's disease Hepatology business.industry Remission Induction Gastroenterology Retrospective cohort study Middle Aged medicine.disease Discontinuation Methotrexate Treatment Outcome 030220 oncology & carcinogenesis Concomitant Drug Therapy Combination Female 030211 gastroenterology & hepatology business Immunosuppressive Agents medicine.drug |
| Zdroj: | European Journal of Gastroenterology & Hepatology, 28(7), 802-806. Lippincott Williams & Wilkins |
| ISSN: | 0954-691X |
| DOI: | 10.1097/meg.0000000000000609 |
| Popis: | IntroductionMethotrexate (MTX) has been utilized for the treatment of Crohn's disease (CD) for decades. Nevertheless, current data provide equivocal evidence on the efficacy of MTX in CD.The aims of this study were to describe the efficacy of MTX for maintenance of remission in CD and to identify the factors associated with the probability of steroid-free clinical remission in a multicenter European referral center cohort.Patients and methodsThis was a retrospective cohort analysis. Consecutive patients treated with MTX for CD were included from 11 referral centers. Patients receiving concomitant treatment with tumor necrosis factor inhibitors or thiopurines were excluded. The main outcome was steroid-free clinical remission; the secondary outcomes included the rate of complications leading to MTX discontinuation and duration of relapse-free survival in patients achieving the main outcome.ResultsBetween July 1992 and January 2012, 118 patients were identified for inclusion. MTX administration route was oral for induction in 31.4% and for maintenance in 49.1% of the patients. Steroid-free remission was achieved in 44/118 (37.2%) patients and was maintained relapse free by 28/44 (63.6%) for a median of 12 (3.5-18.5) months. At least one adverse effect was reported by 28.9% of the patients. No clinical or demographic factors were associated with either likelihood of achieving a clinical response or duration of relapse-free survival.ConclusionMTX treatment induced steroid-free clinical remission in over a third of CD patients and maintained it for a year in almost two-thirds of the responders. MTX should be considered a viable therapeutic option in CD patients refractory to other therapies. |
| Databáze: | OpenAIRE |
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