Please use this identifier to cite or link to this item: https://hdl.handle.net/20.500.11851/8726
Title: Parenteral Methotrexate Is Efficient in the Treatment of Azathioprine Refractory Crohn's Disease
Authors: Gokbulut, Volkan
Ozin, Yasemin
Kalkan, İsmail Hakkı
Arr, Derya
Yuksel, Mahmut
Kilic, Zeki Mesut Yalin
Kayacetin, Ertugrul
Keywords: Azathioprine
methotrexate
refractory Crohn's disease
Long-Term Efficacy
Thiopurines
Risk
Issue Date: 2022
Publisher: Aves
Source: Gökbulut, V., Özin, Y., Kalkan, İ. H., Arı, D., Yüksel, M., Kılıç, Z. M. Y., & Kayaçetin, E. (2022). Parenteral Methotrexate Is Efficient in the Treatment of Azathioprine Refractory Crohn’s Disease. The Turkish Journal of Gastroenterology, 33(2), 111.
Abstract: Background: There is limited data in the literature analyzing the efficacy of methotrexate in Crohn's disease used after thiopurine analogs. We aimed in our study to show the efficacy of methotrexate in Crohn's disease patients who failed to respond to thiopurine treatment. Methods: The study included 29 azathioprine refractory patients with Crohn's disease. Intramuscular methotrexate (25 mg/week) in the induction of remission and intramuscular methotrexate (15 mg/week) in 29 CD patients with a median follow-up time of 13 months was performed. In 15 (51.7%) patients, methotrexate was used in combination with anti-Tumour necrosis factor (TNF) (combination group), while it was used in 14 (48.3%) patients in monotherapy (monotherapy group). Results: The mean Harvey-Bradshaw index score significantly decreased in the follow-up period (Wk0 = 7.6, last visit = 4.5, P < .001). Remission and response rates at week 12 were 75.9% and 79.3%, respectively. Maintenance of remission (77.8% vs 37.5%, respectively, P=.1)and response rates (77.8% vs 50%, respectively, P = .3) due to last visit examination were numerically higher in combination group but they were not statistically significant. The cumulative probability of remission maintenance in patients with methotrexate therapy was 72.7%, 33.1%, and 22.0% at 1, 2 ,and 4 years after starting methotrexate, respectively. Conclusion: Our results show that parenteral use of methotrexate is efficacious in inducing and maintaining remission as a step-up agent in azathioprine refractory Crohn's disease patients.
URI: https://doi.org/10.5152/tjg.2022.21459
https://hdl.handle.net/20.500.11851/8726
ISSN: 2148-5607
Appears in Collections:Dahili Tıp Bilimleri Bölümü / Department of Internal Medical Sciences
PubMed İndeksli Yayınlar Koleksiyonu / PubMed Indexed Publications Collection
Scopus İndeksli Yayınlar Koleksiyonu / Scopus Indexed Publications Collection
WoS İndeksli Yayınlar Koleksiyonu / WoS Indexed Publications Collection

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