Methotrexate for the Treatment of Pediatric Crohn’s Disease: A Systematic Review and Meta-analysis

Colman, Ruben J.; Lawton, Rachel; Dubinsky, Marla; Rubin, David T.

doi:10.1093/ibd/izy078

Cited by 34 publications

(17 citation statements)

References 24 publications

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“…Methotrexate has proven useful in the management of adults with refractory collagenous colitis, and we now report the first case of a child with extensive collagenous mucosal involvement successfully treated with methotrexate [15]. Methotrexate was chosen due to existing data demonstrating its favorable risk/benefit profile for use in the treatment of children with inflammatory and rheumatologic diseases [16,17].…”

Section: Discussionmentioning

confidence: 99%

Pediatric Collagenous Gastroenterocolitis Successfully Treated with Methotrexate

Beinvogl

Goldsmith

Arumugam

et al. 2020

Case Reports in Pediatrics

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A two-and-one-half-year-old previously healthy female presented with a ten-week history of watery diarrhea, nonbilious and nonbloody emesis, and low-grade fevers. She was found to have severe hypoalbuminemia and hypogammaglobulinemia. Her symptoms persisted, and she became dependent on parenteral nutrition. Biopsies obtained during subsequent endoscopic and colonoscopic studies revealed findings consistent with collagenous gastroenterocolitis. She responded to an empiric course of prednisone, but her symptoms recurred shortly after transitioning to oral budesonide. After successful reinduction with intravenous prednisone, intramuscular methotrexate was initiated. She remained asymptomatic during a 15-month course of therapy, and she continued to do well clinically until approximately nine months after weaning off methotrexate. At that point, she experienced a recurrence of diarrhea, and repeat endoscopic evaluation confirmed collagenous colitis. is responded nicely to a short course of oral budesonide, and she has since remained asymptomatic and off any therapy.

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Section: Discussionmentioning

confidence: 99%

Pediatric Collagenous Gastroenterocolitis Successfully Treated with Methotrexate

Beinvogl

Goldsmith

Arumugam

et al. 2020

Case Reports in Pediatrics

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“…The pooled achieved clinical remission rate for pediatric CD patients on monotherapy within 3–6 months was 57.7% (95% CI 48.2–66.6%) ( P = 0.22; I 2 = 29.8%). The clinical remission was 37.1% (95% CI 29.5–45.5%) ( P = 0.20; I 2 = 37.4%) for maintenance therapy at 12 months 71 . In general, MTX given orally has significant variability in bioavailability among individuals; subcutaneous injection is the preferred formulation 73 .…”

Section: Methotrexatementioning

confidence: 99%

“…It is not useful in the management of UC 68– 70 . Most of the evidence for efficacy in pediatric patients comes from several retrospective pediatric series, a recent systematic review 71 , and extrapolated information from one randomized placebo-controlled trial in adults with CD 72 . The pooled achieved clinical remission rate for pediatric CD patients on monotherapy within 3–6 months was 57.7% (95% CI 48.2–66.6%) ( P = 0.22; I 2 = 29.8%).…”

Section: Methotrexatementioning

confidence: 99%

Recent advances in understanding and managing pediatric inflammatory bowel disease

Gurram¹,

Patel²

2019

F1000Res

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The landscape of pediatric inflammatory bowel disease is rapidly evolving. The therapeutic advances seen in the adult arena are rapidly being adopted by pediatric gastroenterologists and evaluated in both controlled trials and real-world experience. Though anti-tumor necrosis factor agents have been the primary therapy over the last decade, recently there has been an expansion of therapeutic targets and alternative mechanism of action drugs with a focus on individualized and personalized therapy. By reviewing epidemiology, pathophysiology, and goals of treatment, we hope to frame the discussion of current and novel therapeutics for the pediatric gastroenterologist. As scientific discovery continues to push the envelope in defining our understanding of pediatric inflammatory bowel disease, the current era of therapeutics gives us hope that a cure may be realized soon.

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“…Bei chronischem Steroidbedarf ist auch bei Kindern und Jugendlichen mit M. Crohn der Steroid-sparende Effekt von Azathioprin [394], Methotrexat [395] und TNF-α-Antikörpern [396] gut belegt. Die primäre Remissions-induzierende Therapie mit TNF-α-Antikörpern wird bei Vorliegen von Risikofaktoren für einen schlechten Verlauf entsprechend der aktuellen europäischen Leitlinie empfohlen [220].…”

Section: Kommentarunclassified

Aktualisierte S3-Leitlinie „Diagnostik und Therapie des Morbus Crohn“ der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) – August 2021 – AWMF-Registernummer: 021-004

Sturm

Atreya

Bettenworth³

et al. 2022

Z Gastroenterol

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Kinder und Jugendliche Fertilität Medikamente in der Schwangerschaft und Stillzeit Entbindung Impfungen des Neugeborenen Der*die ältere CED-Patient*in M. Crohn -Leitlinie AG 07 Ernährung Ernährung Ernährung als Krankheitsauslöser beim M. Crohn Ernährung als ein den Krankheitsverlauf modulierender Faktor Ernährung als therapeutischer Ansatz bei Patient*innen mit M. Crohn Ernährung zur Behandlung von Defiziten bzw. Mangelzuständen

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Methotrexate for the Treatment of Pediatric Crohn’s Disease: A Systematic Review and Meta-analysis

Cited by 34 publications

References 24 publications

Pediatric Collagenous Gastroenterocolitis Successfully Treated with Methotrexate

Pediatric Collagenous Gastroenterocolitis Successfully Treated with Methotrexate

Recent advances in understanding and managing pediatric inflammatory bowel disease

Aktualisierte S3-Leitlinie „Diagnostik und Therapie des Morbus Crohn“ der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) – August 2021 – AWMF-Registernummer: 021-004

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