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Gastroenterol Hepatol. 2015 Jan;38(1):24-30. doi: 10.1016/j.gastrohep.2014.10.002. Epub 2014 Nov 13.

[Reccomendations of the Spanish Working Group on Crohn's Disease and Ulcerative Colitis (GETECCU) on the use of methotrexate in inflammatory bowel disease].

[Article in Spanish]

Author information

1
Servicio de Aparato Digestivo, Hospital Clínico Universitario Lozano Blesa, Zaragoza, IIS Aragón, España Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD). Electronic address: fgomollon@gmail.com.
2
Servicio de Aparato Digestivo, Hospital de Navarra, PamplonaEspaña.
3
Servicio de Aparato Digestivo, Hospital Royo Villanova, Zaragoza España.
4
Servicio de Aparato Digestivo, Hospital Universitario Miguel Servet, Zaragoza, España.
5
Servicio de Aparato Digestivo, Hospital de León, León España.
6
Servicio de Aparato Digestivo, Hospital Universitario de la Princesa, Instituto de Investigación Sanitaria Princesa (IP), Madrid España, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD).
7
Servicio de Aparato Digestivo, Hospital Germans Trías i Pujol, Badalona España, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD).

Abstract

Methotrexate is an immunosuppressant that may be useful in several clinical scenarios in inflammatory bowel disease. In this article, we review the available evidence in Crohn's disease and ulcerative colitis and establish general recommendations for its use in clinical practice. Although the available data are limited, it is very likely that methotrexate is underused because its effectiveness is underestimated and its toxicity is overestimated. Both in induction therapy and in maintenance of remission, methotrexate is useful in Crohn's disease. When prescribed in combination with biologic agents, immunogenicity is less frequent and consequently long-term response could potentially be improved. There are few published studies, but several data suggest that methotrexate could also be useful in ulcerative colitis. Although myelotoxicity and liver toxicity are well known risks, methotrexate is a drug that is well tolerated in many patients, even in the long term.

KEYWORDS:

Colitis ulcerosa; Crohn's disease; Enfermedad de Crohn; Immunosuppression; Inmunosupresión.; Methotrexate; Metotrexato; Ulcerative colitis

PMID:
25454602
DOI:
10.1016/j.gastrohep.2014.10.002
[Indexed for MEDLINE]

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