Efficacy of methotrexate in pediatric Crohn's disease: a French multicenter study
| Autor: | R Belbouab, Jacques Schmitz, S Uhlen, Jean-Pierre Cézard, Frank M. Ruemmele, Dominique Turck, Olivier Goulet, K Narebski |
|---|---|
| Rok vydání: | 2006 |
| Předmět: |
musculoskeletal diseases
Male medicine.medical_specialty Time Factors medicine.drug_class Nausea Azathioprine Gastroenterology Crohn Disease Internal medicine medicine Immunology and Allergy Humans heterocyclic compounds Treatment Failure Child Retrospective Studies Crohn's disease business.industry Remission Induction Retrospective cohort study medicine.disease Discontinuation Surgery Methotrexate Treatment Outcome Toxicity Corticosteroid Female medicine.symptom business Immunosuppressive Agents medicine.drug Follow-Up Studies |
| Zdroj: | Inflammatory bowel diseases. 12(11) |
| ISSN: | 1078-0998 |
| Popis: | Background: Immunosuppressors play a major role in maintaining remission in Crohn's disease (CD). In patients who do not tolerate or escape therapy with azathioprine (AZA)/6-mercaptopurine, there is a marked need for other immunosuppressive drugs. The aim of the present study was to evaluate the efficacy and safety of methotrexate (MTX) in children with active CD. Methods: In a retrospective multicenter (n = 3) study, the efficacy of MTX to induce complete remission or a clinical improvement was analyzed in 61 children with active CD. Results: CD was diagnosed at a mean age of 11.1 ± 2.3 years, and MTX was introduced 3.1 ± 2.2 years after diagnosis. Indications to use MTX were a nonresponse to or relapse under AZA (n = 42) or AZA intolerance/toxicity (n = 19). MTX improved or induced complete remission in 49 patients (80%), of whom 18 (29.5%) relapsed after 13 ± 10 months of treatment. Under MTX medication, complete remission was observed in 39%, 49%, and 45% at 3, 6, and 12 months, respectively. Follow-up over at least 24 months in 11 children confirmed a sustained remission on MTX monotherapy up to 40 months. Adverse reactions were observed in 14 patients (24%), requiring discontinuation of MTX in 6 children (10%) (liver enzyme elevation, n = 2; varicella-zoster, n = 1; nausea, n = 3). MTX allowed corticosteroid discontinuation in 36 patients. Conclusions: MTX improved the clinical course in most pediatric CD patients who escaped or did not tolerate AZA. Short-time toxicity of MTX resulted in drug discontinuation in |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text