Methotrexate therapy

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Through a variety of mechanisms including folate independent pathways, once weekly low-dose methotrexate, either oral or parenteral, has been demonstrated to exert immune-modifying effects. The currently published data shows the efficacy of methotrexate in Crohn disease while convincing data for ulcerative colitis is lacking. While there is robust prospective data in adult Crohn disease, the current data in pediatric patients is largely retrospective. However, there is strongly favorable data in juvenile rheumatoid arthritis patients. Until there is prospective, long-term efficacy and safety data on methotrexate in pediatric IBD, it is reasonable to consider the thiopurines to be the first line immunomodulators in this setting. The teratogenicity of methotrexate stands out as a distinguishing toxicity concern. Accordingly, for patients who are not of child-bearing potential and who do not respond or who cannot tolerate the thiopurines, methotrexate is a promising second line immunomodulator.

Original languageEnglish (US)
Title of host publicationPediatric Inflammatory Bowel Disease
PublisherSpringer US
Pages379-386
Number of pages8
ISBN (Print)9780387734804
DOIs
StatePublished - Dec 1 2008
Externally publishedYes

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Methotrexate
Immunologic Factors
Crohn Disease
Pediatrics
Therapeutics
Juvenile Arthritis
Ulcerative Colitis
Folic Acid
Safety

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Rosh, J. R. (2008). Methotrexate therapy. In Pediatric Inflammatory Bowel Disease (pp. 379-386). Springer US. https://doi.org/10.1007/978-0-387-73481-1_30
Rosh, Joel R. / Methotrexate therapy. Pediatric Inflammatory Bowel Disease. Springer US, 2008. pp. 379-386
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Rosh, JR 2008, Methotrexate therapy. in Pediatric Inflammatory Bowel Disease. Springer US, pp. 379-386. https://doi.org/10.1007/978-0-387-73481-1_30

Methotrexate therapy. / Rosh, Joel R.

Pediatric Inflammatory Bowel Disease. Springer US, 2008. p. 379-386.

Research output: Chapter in Book/Report/Conference proceedingChapter

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Rosh JR. Methotrexate therapy. In Pediatric Inflammatory Bowel Disease. Springer US. 2008. p. 379-386 https://doi.org/10.1007/978-0-387-73481-1_30