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Methotrexate for maintenance of remission in Crohn's disease

  1. Vishal Patel1,
  2. Yongjun Wang2,
  3. John K MacDonald2,
  4. John WD McDonald2,
  5. Nilesh Chande3,*

Editorial Group: Cochrane IBD Group

Published Online: 26 AUG 2014

Assessed as up-to-date: 9 JUN 2014

DOI: 10.1002/14651858.CD006884.pub3


How to Cite

Patel V, Wang Y, MacDonald JK, McDonald JWD, Chande N. Methotrexate for maintenance of remission in Crohn's disease. Cochrane Database of Systematic Reviews 2014, Issue 8. Art. No.: CD006884. DOI: 10.1002/14651858.CD006884.pub3.

Author Information

  1. 1

    North York General Hospital, Toronto, ON, Canada

  2. 2

    Robarts Research Institute, Robarts Clinical Trials, London, ON, Canada

  3. 3

    London Health Sciences Centre - Victoria Hospital, London, ON, Canada

*Nilesh Chande, London Health Sciences Centre - Victoria Hospital, Room E6-321A, 800 Commissioners Road East, London, ON, N6A 5W9, Canada. nilesh.chande@lhsc.on.ca. nchande2@uwo.ca.

Publication History

  1. Publication Status: New search for studies and content updated (conclusions changed)
  2. Published Online: 26 AUG 2014

SEARCH

References

References to studies included in this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
  4. References to other published versions of this review
Feagan 2000 {published data only}
  • Feagan BG, Fedorak RN, Irvine EJ, Wild G, Sutherland L, Steinhart AH, et al. A comparison of methotrexate with placebo for the maintenance of remission in Crohn's disease. New England Journal of Medicine 2000;342(22):1627-32. [PUBMED: 2000197470]
  • Feagan BG, Fedorak RN, Irvine EJ, Wild GE, Sutherland LR, Steinhart AH, et al. A comparison of methotrexate with placebo for the maintenance for the maintenance of remission in Crohn's disease. Gastroenterology 2000;118(4 Suppl 2):A190.
Feagan 2014 {published data only}
  • Feagan B, McDonald JW, Panaccione R, Enns RA, Bernstein CN, Ponich TP, et al. A randomized trial of methotrexate in combination with infliximab for the treatment of Crohn’s disease. Gastroenterology 2008;135(1):294-5.
  • Feagan BG, McDonald JWD, Panaccione R, Enns R, Bernstein CN, Ponich T, et al. A randomized trial of methotrexate in combination with infliximab for the treatment of Crohn's disease. United European Gastroenterology Week. Vienna, Austria, 2008:Abstract OP301.
  • Feagan BG, McDonald JWD, Panaccione R, Enns RA, Bernstein CN, Ponich TP, et al. Methotrexate in combination with infliximab is no more effective than infliximab alone in patients with Crohn's disease. Gastroenterology 2014;146(3):681-8. [PUBMED: 24269926]
Maté-Jiménez 2000 {published data only}
  • Hermida C, Cantero J, Moreno-Otero R, Maté-Jiménez J. Methotrexate and 6-mercaptopurine in steroid-dependent inflammatory bowel disease patients: a randomized controlled clinical trial. 1999 Gut;45(Suppl V):A132.
  • Maté-Jiménez J, Hermida C, Cantero-Perona J, Moreno-Otero R. 6-Mercaptopurine or methotrexate added to prednisone induces and maintains remission in steroid-dependent inflammatory bowel disease. European Journal of Gastroenterology and Hepatology 2000;12(11):1227-33. [PUBMED: 11111780]
Oren 1997 {published data only}
  • Oren R, Moshkowitz M, Odes S, Becker S, Keter D, Pomeranz I, et al. Methotrexate in chronic active Crohn's disease: a double-blind, randomized, Israeli multicenter trial. American Journal of Gastroenterology 1997;92(12):2203-9. [PUBMED: 1997381066]
Schröder 2006 {published data only}
  • Schröder O, Blumenstein I, Stein J. Combining infliximab with methotrexate for the induction and maintenance of remission in refractory Crohn's disease: a controlled pilot study. European Journal of Gastroenterology and Hepatology 2006;18(1):11-6. [PUBMED: 16357613]

References to studies excluded from this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
  4. References to other published versions of this review
Ardizzone 2003 {published data only}
  • Ardizzone S, Bollani S, Manzionna G, Imbesi V, Colombo E, Bianchi Porro G. Comparison between methotrexate and azathioprine in the treatment of chronic active Crohn's disease: a randomised, investigator-blind study. Digestive and Liver Disease 2003;35(9):619-27. [PUBMED: 14563183]
  • Ardizzone S, Bollani S, Manzionna G, Molteni P, Bareggi E, Bianchi Porro G. Controlled trial comparing intravenous methotrexate and oral azathioprine for chronic active Crohn's disease: preliminary report. Gastroenterology 1999;116(4 (Part 2)):A662-3.
  • Bianchi Porro G, Ardizzone S, Bollani S, Duca A, Manzionna G, Molteni P. Controlled trial comparing intravenous methotrexate and oral azathioprine for chronic active Crohn's disease: preliminary report. Gut 1982;23(10):295.
Arora 1999 {published data only}
  • Arora S, Katkov W, Cooley J, Kemp JA, Johnston DE, Schapiro RH, et al. Methotrexate in Crohn's disease: results of a randomized, double-blind, placebo-controlled trial. Hepatogastroenterology 1999;46(27):1724-9. [PUBMED: 10430331]
  • Arora S, Katkov WN, Cooley J, Kemp A, Schapiro RH, Kelsey PB, et al. A double blind, randomized, placebo-controlled trial of methotrexate in Crohn's disease. Gastroenterology 1992;102(4 Part 2):A591.
Clark 2005 {published data only}
  • Clark LL, Lightbody E, Morgan A, Gaya D, Winter JW, Gillespie RJ. The efficacy of long term intramuscular methotrexate in difficult to treat Crohn's disease. Gastroenterology 2005;136(5 Suppl 1):A659.
Domènech 2008 {published data only}
  • Domènech E, Mañosa M, Navarro M, Masnou H, Garcia-Planella E, Zabana Y, et al. Long-term methotrexate for Crohn's disease: safety and efficacy in clinical practice. Journal of Clinical Gastroenterology 2008;42(4):395-9. [PUBMED: 18277899]
Egan 1999a {published data only}
  • Egan L, Sandborn W, Tremaine W, Leighton J, Mays D, Pike M, et al. A randomized, single-blind, pharmacokinetic and dose response study of subcutaneous methotrexate, 15 and 25 mg/week, for refractory ulcerative colitis and Crohn's disease. Gastroenterology 1998;114(4 Pt2):A-227.
  • Egan LJ, Sandborn WJ, Tremaine WJ, Leighton JA, Mays DC, Pike MG, et al. A randomized dose-response and pharmacokinetic study of methotrexate for refractory inflammatory Crohn's disease and ulcerative colitis. Alimentary Pharmacology and Therapeutics 1999;13(12):1597-604. [PUBMED: 10594394]
Feagan 1995 {published data only}
  • Feagan BG, North American Crohn's Study Group Investigators. A Multicentre trial of methotrexate (MTX) for chronically active Crohn's disease (CD). Gut 1994;35 Suppl 4:A121.
  • Feagan BG, Rochon J, Fedorak RN, Irvine EJ, Wild G, Sutherland L, et al. Methotrexate for the treatment of Crohn's disease. New England Journal of Medicine 1995;332(5):292-7. [PUBMED: 7816064]
  • Investigators, T.N.A.C.s.S.G. A multicentre trial of methotrexate (MTX) treatment for chronically active Crohn's disease. Gastroenterology 1994;106(4 Part 2):A745.
Fishman 2001 {published data only}
  • Fishman M. Methotrexate and maintenance of remission in Crohn's disease. Canadian Journal of Gastroenterology 2001;15(7):428. [PUBMED: 11493943]
Hayee 2005 {published data only}
  • Hayee BH, Harris AW. Methotrexate for Crohn's disease: experience in a district general hospital. European Journal of Gastroenterology and Hepatology 2005;17(9):893-8. [PUBMED: 16093864]
Houben 1994 {published data only}
  • Houben MH, Wijk HJ, Driessen WM, Spreeuwel JP. Methotrexate as possible treatment in refractory chronic inflammatory intestinal disease. Nederlands Tijdschrift voor Geneeskunde 1994;138(51):2552-6. [PUBMED: 7830804]
Kurnik 2003 {published data only}
Lahaire 2011 {published data only}
Lampen-Smith 2011 {published data only}
  • Lampen-Smith A, Khan I, Claydon A. Methotrexate in patients with Crohn's disease: a regional experience. Journal of Gastroenterology and Hepatology 2011;26:61-2. [PUBMED: 70627238]
Lémann 2000 {published data only}
  • Lémann M, Zenjari T, Bouhnik Y, Cosnes J, Mesnard B, Rambaud JC, et al. Methotrexate in Crohn's disease: long-term efficacy and toxicity. American Journal of Gastroenterology 2000;95(7):1730-4. [PUBMED: 10925976]
Martreau 2000 {published data only}
  • Martreau P. A comparison of methotrexate with placebo for the maintenance of remission in Crohn's disease. North American Crohn's Study Group Investigators [Demonstration de l'efficacite du methotrexate par voie parenterale pour maintenir en remission la maladie de Crohn]. Gastroenterologie Clinique et Biologique 2000;24(12):1243-4. [PUBMED: 11277090]
Roseau 2000 {published data only}
  • Roseau E. Crohn's disease: prevention of relapse with methotrexate or growth hormone [Maladie de Crohn: Prevention des rechutes par le methotrexate ou l'hormone de croissance]. Presse Medicale 2000;29(30):1652-3. [PUBMED: 11089504]
Roznowski 2001 {published data only}
  • Roznowski AB, Dignass A. Sustaining remission in Crohn disease with methotrexate--a placebo controlled study [Remissionserhaltung bei Morbus Crohn mit Methotrexat--eine plazebokontrollierte Untersuchung]. Zeitschrift fur Gastroenterologie 2001;39(3):265-7. [PUBMED: 11324144]
Schröder 1996 {published data only}
  • Schröder O, Stein J. Methotrexate in therapy of chronic inflammatory bowel diseases [Methotrexat (MTX) in der Therapie chronische-entzundlicher Darmerkrankungen]. Zeitschrift fur Gastroenterologie 1996;34(7):457-8. [PUBMED: 8928541]
Suares 2012 {published data only}
Sun 2005 {published data only}
Wilson 2013 {published data only}
Yang 2001 {published data only}
  • Yang YX, Lichtenstein GR. Methotrexate for the maintenance of remission in Crohn's disease. Gastroenterology 2001;120(6):1553-5. [PUBMED: 11313329]

Additional references

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
  4. References to other published versions of this review
Arthur 2002
Baert 2003
  • Baert F, Noman M, Vermeire S, Van Assche G, D' Haens G, Carbonez A, et al. Influence of immunogenicity on the long-term efficacy of infliximab in Crohn's disease. New England Journal of Medicine 2003;348(7):601-8. [PUBMED: 12584368]
Balis 1988
  • Balis FM, Mirro J Jr, Reaman GH, Evans WE, McCully C, Doherty KM, et al. Pharmacokinetics of subcutaneous methotrexate. Journal of Clinical Oncology 1988;6(12):1882-6. [PUBMED: 3199171]
Chebli 2007
  • Chebli JM, Gaburri PD, De Souza AF, Pinto AL, Chebli LA, Felga GE, et al. Long-term results with azathioprine therapy in patients with corticosteroid-dependent Crohn's disease: open-label prospective study. Journal of Gastroenterology and Hepatology 2007;22(2):268-74. [PUBMED: 17295882]
Egan 1999b
Guyatt 2008
  • Guyatt GH, Oxman AD, Vist GE, Kunz R, Falck-Ytter Y, Alonso-Coello P, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ 2008;336(7650):924-6.
Hanauer 2002
  • Hanauer SB, Feagan BG, Lichtenstein GR, Mayer LF, Schreiber S, Colombel JF, et al. Maintenance infliximab for Crohn's disease: the ACCENT I randomised trial. Lancet 2002;359(9317):1541-9. [PUBMED: 12047962]
Higgins 2003
Higgins 2011
  • Higgins JPT, Altman DG, Sterne JAC (editors). Chapter 8: Assessing risk of bias in included studies. In: Higgins JPT, Green S editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from www.cochrane-handbook.org.
Lichtenstein 2006
  • Lichtenstein GR, Abreu MT, Cohen R, Tremaine W, American Gastroenterological Association. American Gastroenterological Association Institute medical position statement on corticosteroids, immunomodulators, and infliximab in inflammatory bowel disease. Gastroenterology 2006;130(3):935-9. [PUBMED: 16530531]
McDonald 2014
  • McDonald JWD, Wang Y, Tsoulis DJ, MacDonald JK, Feagan BG. Methotrexate for induction of remission in refractory Crohn's disease. Cochrane Database of Systematic Reviews 2014, Issue 8. [DOI: 10.1002/14651858.CD003459.pub4]
Prefontaine 2009
Rampton 2001
Schünemann 2011
  • Schünemann HJ, Oxman AD, Vist GE, Higgins JPT, Deeks JJ, Glasziou P, et al. Chapter 12: Interpreting results and drawing conclusions. In: Higgins JPT, Green S editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from www.cochrane-handbook.org.
Steinhart 2003
  • Steinhart AH, Ewe K, Griffiths AM, Modigliani R, Thomsen OO. Corticosteroids for maintenance of remission in Crohn's disease. Cochrane Database of Systematic Reviews 2003, Issue 4. [DOI: 10.1002/14651858.CD000301]

References to other published versions of this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
  4. References to other published versions of this review
Patel 2009