Methotrexate in ulcerative colitis: a Spanish multicentric study on clinical use and efficacy.
J Crohns Colitis
; 5(5): 397-401, 2011 Oct.
Article
em En
| MEDLINE
| ID: mdl-21939912
ABSTRACT
BACKGROUND:
Few data are available on the efficacy of methotrexate (MTX) in ulcerative colitis (UC).AIM:
To evaluate the efficacy and safety of MTX in UC patients. PATIENTS ANDMETHODS:
UC patients who had been treated with MTX were identified from the databases of 8 Spanish IBD referral hospitals. Patients were included in the study if they received MTX for steroid dependency or steroid refractoriness. Therapeutic success was defined as the absence of UC-related symptoms, complete steroid withdrawal and no requirement of rescue therapies within the first 6 months after starting MTX.RESULTS:
Forty patients were included, 70% treated for steroid dependency and 27% for steroid refractoriness. Thiopurines had been previously attempted in 87.5% of patients. The median dose of MTX used for induction was 25mg (IIQ 17.5-25) weekly given parenterally in 82.5% of cases. Eighty-five percent of patients were on steroids when MTX was started. Forty-five percent of patients met criteria for therapeutic success. Initial treatment failures were mainly due to inefficacy (50%) or intolerance (36%). After a median follow-up of 28 months (IQR 22-47), 38% of patients with initial therapeutic success required new steroid courses, 22% started biological therapy, and only 1 patient required colectomy. The cumulative probability of maintaining steroid-free clinical remission was 60%, 48%, and 35% at 6, 12, and 24 months after starting MTX, respectively. Eleven patients (27.5%) experienced adverse events, leading to MTX discontinuation in only 8 of them.CONCLUSIONS:
MTX appears to be effective to maintain clinical remission in UC, at least in the short-term, with an acceptable safety profile.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Colite Ulcerativa
/
Metotrexato
/
Imunossupressores
Tipo de estudo:
Evaluation_studies
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Observational_studies
/
Prognostic_studies
Limite:
Adult
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Aged
/
Aged80
/
Female
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Humans
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Male
/
Middle aged
País/Região como assunto:
Europa
Idioma:
En
Ano de publicação:
2011
Tipo de documento:
Article