Efficacy of methotrexate in Crohn's disease and ulcerative colitis patients unresponsive or intolerant to azathioprine/mercaptopurine

Alimentary Pharmacology and Therapeutics

Volumn 30, Issue 6, 2009, Pages 614-620

  Wahed, M ^a,b   Louis Auguste, J R ^a   Baxter, L M ^b   Limdi, J K ^a   Mccartney, S A ^a   Lindsay, J O ^b   Bloom, S L ^a  

^a UNIVERSITY COLLEGE LONDON HOSPITALS   (United Kingdom)

^b QUEEN MARY UNIVERSITY OF LONDON   (United Kingdom)

Author keywords

[No Author keywords available]

Indexed keywords

ANTIBIOTIC AGENT; AZATHIOPRINE; FOLIC ACID; INFLIXIMAB; MERCAPTOPURINE; MESALAZINE; METHOTREXATE; STEROID; TUMOR NECROSIS FACTOR ALPHA ANTIBODY;

ADOLESCENT; ADULT; AGED; ARTHRALGIA; ARTICLE; BONE MARROW SUPPRESSION; CLINICAL ASSESSMENT; COHORT ANALYSIS; COLON CROHN DISEASE; CONTROLLED STUDY; CROHN DISEASE; DISEASE DURATION; DRUG DOSE REDUCTION; DRUG EFFICACY; DRUG HYPERSENSITIVITY; DRUG SAFETY; DRUG TOLERABILITY; DRUG TOLERANCE; DRUG WITHDRAWAL; DYSPNEA; FEMALE; FLU LIKE SYNDROME; GASTROINTESTINAL SYMPTOM; HAIR LOSS; HUMAN; LIVER FUNCTION TEST; MAINTENANCE DRUG DOSE; MAJOR CLINICAL STUDY; MALAISE; MALE; NAUSEA AND VOMITING; NEUTROPENIA; OSTEOMYELITIS; PANCREATITIS; PRIORITY JOURNAL; RASH; RETROSPECTIVE STUDY; SIDE EFFECT; TREATMENT RESPONSE; ULCERATIVE COLITIS;

6-MERCAPTOPURINE; ADOLESCENT; ADULT; AGED; AGED, 80 AND OVER; AZATHIOPRINE; DRUG HYPERSENSITIVITY; DRUG RESISTANCE; FEMALE; HUMANS; IMMUNOSUPPRESSIVE AGENTS; INFLAMMATORY BOWEL DISEASES; MALE; METHOTREXATE; MIDDLE AGED; TREATMENT OUTCOME; YOUNG ADULT;

EID: 68949209778     PISSN: 02692813     EISSN: 13652036     Source Type: Journal    
DOI: 10.1111/j.1365-2036.2009.04073.x     Document Type: Article

References (34)

1. Candy S, Wright J, Gerber M, et al. A controlled double blind study of azathioprine in the management of Crohn's disease. Gut 1995 37 : 674 8.
2. Hawthorne AB, Logan RF, Hawkey CJ, et al. Randomised controlled trial of azathioprine withdrawal in ulcerative colitis. BMJ 1992 305 : 20 2.
3. Ansari A, Hassan C, Duley J, et al. Thiopurine methyltransferase activity and the use of azathioprine in inflammatory bowel disease. Aliment Pharmacol Ther 2002 16 : 1743 50.
4. Ansari A, Arenas M, Greenfield SM, et al. Prospective evaluation of the pharmacogenetics of azathioprine in the treatment of inflammatory bowel disease. Aliment Pharmacol Ther 2008 28 : 973 83.
5. McGovern DP, Travis SP, Duley J, et al. Azathioprine intolerance in patients with IBD may be imidazole-related and is independent of TPMT activity. Gastroenterology 2002 122 : 838 9.
6. Dubinsky MC, Yang HY, Hassard PV, et al. Pharmacogenomics and metabolite measurements for 6-mercaptopurine therapy in inflammatory bowel disease. Gastroenterology 2000 118 : 705 13.
7. Cuffari C, Hunt S, Bayless T. Utilisation of erythrocyte 6-thioguanine metabolite levels to optimise azathioprine therapy in patients with inflammatory bowel disease. Gut 2001 48 : 642 6.
8. Lowry PW, Franklin CL, Weaver AL, et al. Measurement of thiopurine methyltransferase activity and azathioprine metabolities in patients with inflammatory bowel disease. Gut 2001 49 : 665 70.
9. Feagan BG, Rochon J, Fedorak RN, et al. Methotrexate for the treatment of Crohn's disease. The North American Crohn's Study Group Investigators. N Engl J Med 1995 332 : 292 7.
10. Feagan BG, Fedorak RN, Irvine EJ, et al. A comparison with placebo for the maintenance of remission in Crohn's disease. The North American Crohn's Study Group Investigators. N Engl J Med 2000 342 : 1664 6.
11. Oren R, Arber N, Odes S, et al. Methotrexate in chronic active ulcerative colitis: a double blind, randomised, Israeli multicentre trial. Gastroenterology 1996 110 : 1416 21.
12. Kozarek RA, Patterson DJ, Gelfand MD, et al. Methotrexate induces clinical and histological remission in patients with refractory inflammatory bowel disease. Annals Int Med 1989 110 : 353 6.
13. Paoluzi OA, Pica R, Marcheggiano A, et al. Azathioprine or methotrexate in the treatment of patients with steroid dependent or steroid resistant ulcerative colitis: results of an open-label study on efficacy and tolerability in inducing and maintaining remission. Aliment Pharmacol Ther 2002 16 : 1751 9.
14. Cummings JRF, Herrlinger KR, Travis SPL, et al. Oral methotrexate in ulcerative colitis. Aliment Pharmacol Ther 2005 21 : 385 9.
15. Lemann M, Zenjari T, Bouhnik Y, et al. Methotrexate in Crohn's disease: Long term efficacy and toxicity. Am J Gastroenterol 2000 95 : 35 44.
16. Soon SY, Ansari A, Yaneza M, et al. Experience with the use of low-dose methotrexate for inflammatory bowel disease. Eur J Gastroenter Hepatol 2004 16 : 921 6.
17. Mack DR, Young R, Kaufman SS, et al. Methotrexate in patients with Crohn's disease after 6-mercaptopurine. J Pediatr 1998 132 : 830 5.
18. NRES Ethics Consultation E - Group. Differentiating Audit, Service evaluation and Audit. April 2007. National Research Ethics Service. http://www.nres.npsa.nhs.uk/rec-community/guidance/#researchoraudit accessed on October 10 2008.
19. Feagan BG, McDonald J, Ponich T, et al. A randomized trial of methotrexate (MTX) in combination with infliximab (IFX) for the treatment of Crohn's disease (CD). Gastroenterology 2008 134 : 682c.
20. Din S, Dahele A, Fenel J, et al. Use of methotrexate in refractory Crohn's disease: the Edinburgh experience. Inflamm Bowel Dis 2008 14 : 756 62.
21. Uhlen S, Belbouab R, Narebski O, et al. Efficacy of methotrexate in pediatric Crohn's disease: a French multicentre study. Inflamm Bowel Dis 2006 12 : 1053 7.
22. Vandeputte L, D'Haens G, Baert F, et al. Methotrexate in refractory Crohn's Disease. Inflamm Bowel Dis 1999 5 : 11 5.
23. Morabito L, Montesinos MC, Schreibman DM, et al. Methotrexate and sulfasalazine promote adenosine release by a mechanism that requires ecto-5′-nucleotidase-mediated conversion of adenine nucleotides. J Clin Invest 1998 101 : 295 300.
24. Rampton DS. Methotrexate in Crohn's disease. Gut 2001 48 : 790 1.
25. Genestier L, Paillot R, Fournel S, et al. Immunosuppressive properties of methotrexate: apoptosis and clonal deletion of activated peripheral T cells. J Clin Invest 1998 102 : 322 8.
26. Egan LJ, Sandborn WJ. Methotrexate for inflammatory bowel disease: pharmacology and preliminary results. Mayo Clin Proc 1996 71 : 69 80.
27. Fraser AG, Morton D, McGovern D, et al. The efficacy of methotrexate in maintaining remission in inflammatory bowel disease. Aliment Pharmacol Ther 2002 16 : 693 7.
28. Mate-Jimenez J, Herminda C, Cantero-Perona J, et al. 6 - mercatopurine or methotrexate added to prednisolone induces and maintains remission in steroid dependent inflammatory bowel disease. Eur J Gastroenter Hepatol 2000 12 : 1227 33.
29. Oritz Z, Shea B, Suarez-Almazor ME, et al. The efficacy of folic acid and folinic in reducing methotrexate induced gastrointestinal toxicity in rheumatoid arthritis: a meta-analysis of randomised trials. J Rheumatol 1998 25 : 36 43.
30. Kozarek RA, Bredfeldt JE, Rosoff LE, et al. Does chronic methotrexate (MTX) cause liver toxicity when used for refractory inflammatory bowel disease (IBD)? Gastroenterology 1991 100 : A221. (Abstract)
31. Te HS, Schiano TD, Kuan SF, et al. Hepatic effects of long term methotrexate use in the treatment of inflammatory bowel disease. Am J Gastroenterol 2000 95 : 3150 6.
32. Roenigk HH Jr., Auerbach R, Maibach HI, Weinstein GD. Methotrexate in psoariasis: revised guidelines. J Am Acad Dermatol 1988 19 : 145 56.
33. Kremer JM, Alarcon GS, Lightfoot RW Jr., et al. Methotrexate for rheumatoid arthritis: suggested guidelines for monitoring liver toxicity. Arthritis Rheum 1994 37 : 316 28.
34. Carty E, Rampton DS. Trials and tribulations - interpreting clinical trials in IBD. In : Clinical Dilemmas in Inflammatory Bowel Disease. eds Irving P, Rampton D, Shanahan F. Blackwell Publishing, 2006 : 81 4.