Methotrexate in inflammatory bowel disease

Role of Ursodeoxycholic Acid in Prevention of Methotrexate-induced Liver Toxicity

“…7). Discussion MTX is a well-known chemotherapeutic and immunosuppressive agent that is widely used in many rheumatologic, dermatologic, and hematologic diseases successfully [3][4][5][6][7]. However, its use is limited due to serious side effects such as steatosis, cholestasis, fibrosis, and eventually cirrhosis [26].…”

“…Methotrexate (MTX) is an effective treatment modality largely used in rheumatoid arthritis, psoriasis, leukemias and some other autoimmune disorders for more than 40 years [3,4]. Nowadays it is also used for sarcoidosis, inflammatory bowel disease, and vasculitis [5][6][7]. With this enlarged spectrum of clinical use for MTX, its toxicity on the liver has gained much more importance.…”

Review article: practical management of inflammatory bowel disease patients taking immunomodulators

“…73 Subsequent studies confirmed efficacy in psoriasis and RA, which led to trials in IBD. Methotrexate is a folic acid structural analogue that competitively inhibits the binding of dihydrofolic acid to the enzyme dihydrofolate reductase, involved in purine and pyrimidine synthesis.…”

“…The only head-to-head study comparing methotrexate with AZA was not powered to address the question of rapidity of onset of action, 96 but there was a suggestion that methotrexate may provide clinical benefit earlier than AZA/MP. 73 …”

Review article: The pharmacokinetics and pharmacodynamics of drugs used in inflammatory bowel disease treatment

“…Previous studies had reported that monotherapy MTX was effective in inducing remission and in short-term maintenance therapy. Sustained therapeutic benefit of MTX was estimated to be 63 % after 1 year and 47 % after 2 years of therapy [166][167][168]. The ECCO recommendations for MTX use in CD patients are highlighted in Table 5 Calcineurin inhibitors…”