Comparison between methotrexate and azathioprine in the treatment of chronic active Crohn’s disease: a randomised, investigator-blind study

Ardizzone, Sandro; Bollani, S.; Manzionna, G.; Imbesi, V.; Colombo, Elisabetta; Porro, G. Bianchi

doi:10.1016/s1590-8658(03)00372-4

Cited by 136 publications

(96 citation statements)

References 28 publications

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“…Other studies using low dose methotrexate did not show a significant benefit [23,24] . In addition, no benefit was obserevd when high intravenous methotrexate was compared to oral azathioprine [25] . Like azathioprine/6-mercaptopurine, intramuscular methotrexate is only rarely used to treat an acute exacerbation of CD but is used more frequently in chronic active CD [26] .…”

Section: Methotrexatementioning

confidence: 98%

Conventional therapy for Crohn’s disease

Büning

Lochs²

2006

WJG

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Crohn's disease (CD) is a multifactorial disorder of unknown cause. Outstanding progress regarding the pathophysiology of CD has led to the development of innovative therapeutic concepts. Numerous controlled trials have been performed in CD over the last years. However, many drugs have not been approved by regulatory authorities due to lack of efficacy or severe side effects. Therefore, well-known drugs, including 5-ASA, systemic or topical corticosteroids, and immunosuppressants such as azathioprine, are still the mainstay of CD therapy. Importantly, biologicals such as infliximab have shown to be efficacious in problematic settings such as fistulizing or steroid-dependent CD. This review is intended to give practical guidelines to clinicians for the conventional treatment of CD. We concentrated on the results of randomized, placebo-controlled trials and meta-analyses, when available, that provide the highest degree of evidence. We provide evidence-based treatment algorithms whenever possible. However, many clinical situations have not been answered by controlled clinical trials and it is important to fill these gaps through expert opinions. We hope that this review offers a useful tool for clinicians in the challenging treatment of CD.

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Section: Methotrexatementioning

confidence: 98%

Conventional therapy for Crohn’s disease

Büning

Lochs²

2006

WJG

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“…13 Although methotrexate is as efficacious in inducing remission as azathioprine, it does not appear to work any faster. 14 …”

Section: Ibdmentioning

confidence: 99%

Recommended drug therapy for inflammatory bowel disease

Taylor¹,

Wilkinson²

2012

Prescriber

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“…There was no significant difference between the two groups, suggesting that intravenous methotrexate may be an alternative but no matter which route of administration, methotrexate like azathioprine, has a slow onset of action. 25 There is less evidence for its role in the treatment of ulcerative colitis.…”

Section: Immunosuppressivesmentioning

confidence: 99%

Inflammatory Bowel Disease in Older People

Grimpen¹,

Pavli

2008

Pharmacy Practice and Res

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Inflammatory bowel disease (IBD) can affect patients of all ages. The majority of patients are diagnosed in the second or third decade of life, but a minority develop the disease at an advanced age. Diagnosis can be delayed due to the preconception that IBD mainly affects young people, and the broader spectrum of differential diagnoses in the elderly. Management and treatment options are similar to those in younger patients but adverse reactions and drug interactions may be of greater significance in the elderly. Precluding treatment with anti-tumour necrosis factor drugs on grounds of previous infection with tuberculosis or viral hepatitis, comorbidities or previous malignancy -factors often found with advanced age -can make treatment challenging. The increased risk of bowel cancer in IBD warrants regular screening, especially in the elderly as their absolute risk of cancer is higher.

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Comparison between methotrexate and azathioprine in the treatment of chronic active Crohn’s disease: a randomised, investigator-blind study

Cited by 136 publications

References 28 publications

Conventional therapy for Crohn’s disease

Conventional therapy for Crohn’s disease

Recommended drug therapy for inflammatory bowel disease

Inflammatory Bowel Disease in Older People

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